Agenda 05/28/2013 Item #16E2 5/28/2013 16.E.2.
EXECUTIVE SUMMARY
Recommendation to waive minor irregularities, and award ITB #13-6018,
"Fasteners and Wheel Weights for Fleet," to Lawson Products, Inc.
OBJECTIVE: Obtain quality fasteners, wheel weights, and related products at economical
prices to maintain and repair County vehicles and equipment.
CONSIDERATION: The Fleet Management Department has daily requirements for fasteners,
wheel weights, and related supply products to maintain and repair County vehicles and
equipment. On April 1, 2013, the Purchasing Department posted ITB #13-6018 — Fasteners
and Wheel Weights for Fleet. Staff sent 159 notices to prospective vendors, 24 bid packets
were downloaded and 3 submissions received. In the solicitation, Purchasing requested a
percentage discount off the suppliers' entire catalog. Using that discount(s), the suppliers were
to complete the bid schedule, which included 100 of the County's most used items. The lowest
aggregate total of items on the bid schedule would then be considered the winning bidder.
The proposal from Sunbelt Automotive Supply was deemed non responsive for failing to provide
the requested pricing structure of discount off catalog price, instead stating "cost plus markup,"
without declaring any markup amounts. Parts Associates, Inc., was also deemed non-
responsive for submitting incomplete paperwork.
Lawson Products, Inc. submitted a proposal that identified catalog items into 12 discount
catagories. After review, minor irregularities were found in which the percentage discount did
not match the product prices given on the bid schedule. After the bid closed, Purchasing
contacted the representative from Lawson Products about the discrepancy. Lawson promptly
sent the correct category discounts, which now match the pricing listed on the bid schedule.
This change does not affect the prices offered by Lawson Products, Inc. in its original submitted
bid.
In order to continue the uninterrupted service on the County's vehicle fleet, it is in the best
interest of the County to waive the minor irregularity (Purchasing Policy VI.E), declare the bid of
Lawson Products, Inc., responsive, and award Lawson ITB #13-6018 as the only qualified
bidder. The contract term is one (1) year, with three (3) additional one (1) year renewal options.
FISCAL IMPACT: Funds are budgeted in Fleet Management Administration, Fund 521, to
maintain and repair County vehicles and equipment. Historical spending for this item has been
$70,000 annually.
GROWTH MANAGEMENT IMPACT: No growth management impact will result from this
action.
LEGAL CONSIDERATION: This item has been reviewed by the County Attorney's Office, is
approved as to form and legality, and requires majority vote for approval. -SRT
RECOMMENDATION: That the Board of County Commissioners waive the minor irregularities
and approve the award of ITB #13-6018, "Fasteners and Wheel Weights for Fleet", to Lawson
Products, Inc.
PREPARED BY: Dan Croft, Fleet Management Director
Adam Northrup, Purchasing
Packet Page-2263-
5/28/2013 16.E.2.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.E.16.E.2.
Item Summary: Recommendation to award ITB #13-6018, "Fasteners and Wheel Weights
for Fleet", to Lawson Products, Inc.
Meeting Date: 5/28/2013
Prepared By
Name: EvansLynn
Title: Supervisor-Fleet Operations,Fleet Management
5/10/2013 10:49:26 AM
Submitted by
Title:Director-Fleet Management,Fleet Management
Name: Croft Dan
5/10/2013 10:49:28 AM
Approved By
Name: pochopinpat
Title:Administrative Assistant,Facilities Management
Date: 5/10/2013 3:59:59 PM
Name: MarkiewiczJoanne
Title: Manager-Purchasing Acquisition,Purchasing&Gene
Date: 5/16/2013 9:43:42 AM
Name:NorthrupAdam
Title: Procurement Strategist,Purchasing
Date: 5/16/2013 9:59:52 AM
Name: WardKelsey
Title: Manager-Contracts Administration,Purchasing&Ge
Date: 5/16/2013 10:17:30 AM
Name: PriceLen
Packet Page-2264-
5/28/2013 16.E.2.
Title: Administrator, Administrative Services
Date:5/16/2013 11:09:29 PM
Name: TeachScott
Title: Deputy County Attorney,County Attorney
Date: 5/17/2013 11:02:54 AM
Name: KlatzkowJeff
Title: County Attorney
Date: 5/17/2013 11:13:50 AM
Name: PryorCheryl
Title: Management/Budget Analyst, Senior,Office of Manag
Date: 5/17/2013 11:55:08 AM
Name: IsacksonMark
Title: Director-Corp Financial and Mgmt Svs,CMO
Date: 5/19/2013 10:15:35 AM
ter...;
Packet Page-2265-
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5/28/2013 16.E.2.
Co!! e" Ccaaity Email: adamnorthrup @colliergov.net
Telephone: (239) 252-6098
Administrative Setvices Division FAX: (239) 252-6302
Purchasing
ADDENDUM #1
Memorandum
Date: April 16, 2013
From: Adam Northrup, Procurement Strategist
To: Interested Bidders
Subject: Addendum # 1
13-6018—Fasteners and Wheel Weights
The following change is issued as an addendum identifying the following change (s) for the
referenced solicitation:
Attachment 8 has been updated to remove duplicated line items and provide
additional explanation of various line items.
If you require additional information please post a question on the Online Bidding site or
contact me using the above contact information.
Please sign below and return a copy of this Addendum with your submittal for the above referenced
solicitation.
' w
4/22/13
Si n
( a 9 .,,tore) : ;
Date .'
Lawson Products, Inc,
(Name of Firm)
13-6018
Fasteners and Wheel Weights
Packet Page-2269-
5/28/2013 16.E.2.
.erie " Co #t Email: adamnorthrup @colliergov.net
' Telephone: (239) 252-6098
Adn*nistraave Services Division FAX: (239) 252-6302
Phasing
ADDENDUM #2
Memorandum
Date: April 19, 2013
From: Adam Northrup, Procurement Strategist
To: Interested Bidders
Subject: Addendum #2
13-6018—Fasteners and Wheel Weights
The following change is issued as an addendum identifying the following change (s) for the
referenced solicitation:
Attachment 8 has been updated to correct problems with formulas.
Bid opening date extended by one (1) day to 04/23/2013 at 3:00PM, to allow for
download and completion of corrected Attachment 8.
If you require additional information please post a question on the Online Bidding site or
contact me using the above contact information.
Please sign below and return a copy of this Addendum with your submittal for the above referenced
solicitation.
o•-- - Q.r� 4/22113
(Signature) \J ; 1 Date
Lawson Products,Inc.
(Name of Firm)
13-6018
Fasteners and Wheel Weights
Packet Page-2270-
5/28/2013 16.E.2.
C.goiller County
Administrative Services Division
Purchasing
Attachment 2: Vendor's Check List
IMPORTANT: THIS SHEET MUST BE SIGNED BY VENDOR. Please read carefully, sign in the
spaces indicated and return with bid.
Vendor should check off each of the following items as the necessary action is completed:
1. The Bid has been signed.
2. The Bid prices offered have been reviewed.
3. The price extensions and totals have been checked.
4. The payment terms have been indicated.
5. Any required drawings, descriptive literature, etc. have been included.
6. Any delivery information required is included.
7. If required, the amount of bid bond has been checked, and the bid bond or cashiers check has
been included.
8. Addendum have been signed and included, if applicable.
9. Affidavit for Claiming Status as a Local Business, if applicable.
10. immigration Affidavit and company's E-Verify profile page or memorandum of understanding.
11. Copies of licenses, equipment lists, subcontractors or any other information as noted in this
ITB. Amok
12. The mailing envelope must be addressed to:
Purchasing Director
Collier County Government
Purchasing Department
3327 Tamiami Trail E
Naples FL 34112
The mailing envelope must be sealed and marked with:
• Solicitation: 13-6018—Fasteners and Wheel Weights
• Opening Date: 04/22/2013
13. The bid will be mailed or delivered in time to be received no later than the specified opening
date and time. (Otherwise bid cannot be considered.)
ALL COURIER DELIVERED BIDS MUST HAVE THE BID NUMBER AND TITLE ON THE OUTSIDE
OF THE COURIER PACKET.
Lawson Products, Inc.
Comps y Name
wuct- 1 Cep
Signature &Title
L14 Ut 45
Date
#13-6018 25
Fasteners and Wheel Weights Packet Page-2271-
5/28/2013 16.E.2.
Cott County
Acininistrative seviaes Derision
Purchasing
Attachment 3: Vendor Submittal - Bid Response Form
FROM: Lawson Products, Inc.
Board of County Commissioners
Collier County Government Center
Naples, Florida 34112
RE: Solicitation: 13-6018—Fasteners and Wheel Weights
Dear Commissioners:
The undersigned, as Vendor, hereby declares that the specifications have been fully examined and
the Vendor is fully informed in regard to all conditions pertaining to the work to be performed for as
per the scope of work. The Vendor further declares that the only persons, company or parties
interested in this Bid or the Contract to be entered into as principals are named herein; that this Bid is
made without connection with any other person, company or companies submitting a Bid; and it is all
respects fair and in good faith, without collusion or fraud.
The Vendor proposes and agrees if this Bid is accepted, to contract, either by a County issued
purchase order or formal contract, to comply with the requirements in full in accordance with the
terms, conditions and specifications denoted herein, according to the following unit prices:
1. Percentage Discount from List Price on entire catalog Discounts by Product
Category:
Automotive—47%
Cabinets—23%
Chemicals—55%
Cutting Tools—37%
Electrical—70%
Fluid Power—57%
Fasteners—75%
Hand Tools—52%
Material Handling—52%
Safety—25%
Shop Supplies—30%
Welding—29%
101.Bid Total 11,506.88
Any discounts or terms must be shown on the Bid Response Form. Such discounts, if any, will be
considered and computed in the tabulation of the bids. in no instance should terms for less than
fifteen (15) days payment be offered.
Prompt Payment Terms: 1 % 10 Days; Net 30 Days
#13-6018 26
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5/28/2013 16.E.2.
® Bid Response Form is electronic. Please input line 101. Bid Total, in the online system.
Note: If you choose to bid manually, please submit an ORIGINAL and ONE COPY of your bid
response pages. The undersigned do agree that should this Bid be accepted, to execute a formal
contract, if required, and present the formal contract to the County Purchasing Director for approval
within fifteen (15) days after being notified of an award.
#13-6018 27
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5/28/2013 16.E.2.
IN WITNESS WHEREOF, WE have hereunto subscribed our names on this 22 day of
April , 2013 in the County of Cook , in the State of Illinois .
Firm's Complete Legal Name Lawson Products, Inc.
Address 8770 W. Bryn Mawr Ave., Suite 900
City, State, Zip Chicago, IL 60631-3515
Florida Certificate of Authority F00000001302
Document Number
Federal Tax Identification 80-0496603
Number
CCR#or CAGE Code 57648
Telephone Number 773-304-5050
FAX Number 312-267-1734 `t
Signature/Title _ -� V �C��� .t; �1�c- t t (
Type Name of Signature Frank Ziegler
Date 4/22/13
Additional Contact Information
Send Payments To: (REQUIRED ONLY if different from above)
Firm's Complete Legal Name Lawson Products, Inc.
Address PO Box 809401
City, State, Zip Chicago, IL 60680-9401
Contact Name Brian Carr
Telephone Number 773-304-5219
FAX Number 312-278-0785
Email Address Ardept.usremit(cr�lawsonproducts.com
#13-6018 28
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Co County ; .
Adrninistrafve Services Division
Purchasing
Attachment 4: Vendor Submittal—Local Vendor Preference Affidavit
Solicitation: 13-5018—Fasteners and Wheel Weights(Check Appropriate Boxes Below)
State of Florida(Select County if Vendor is described as a Local Business
❑ Collier County
❑ Lee County
Vendor affirms that it is a local business as defined by the Purchasing Policy of the Collier County Board of
County Commissioners and the Regulations Thereto. As defined in Section XI of the Collier County Purchasing
Policy;
A"local business"is defined as a business that has a valid occupational license issued by either Collier or Lee
County for a minimum of one(1)year prior to a Collier County bid or proposal submission that authorizes the
business to provide the commodities or services to be purchased, and a physical business address located
within the limits of Collier or Lee Counties from which the vendor operates or performs business. Post Office
Boxes are not verifiable and shall not be used for the purpose of establishing said physical address. In addition
to the foregoing, a vendor shall not be considered a"local business" unless it contributes to the economic
development and well-being of either Collier or Lee County in a verifiable and measurable way. This may
include, but not be limited to, the retention and expansion of employment opportunities, the support and
increase to either Collier or Lee County's tax base, and residency of employees and principals of the business
within Collier or Lee County.Vendors shall affirm in writing their compliance with the foregoing at the time of
submitting their bid or proposal to be eligible for consideration as a"local business"under this section.
Vendor must complete the following information:
Year Business Established in❑Collier County or❑ Lee County:
Number of Employees(Including Owner(s)or Corporate Officers):
Number of Employees Living in ❑Collier County or❑ Lee (Including Owner(s)or Corporate Officers):
If requested by the County, vendor will be required to provide documentation substantiating the information
given in this affidavit. Failure to do so will result in vendor's submission being deemed not applicable.
Vendor Name: Date:
Address in Collier or Lee County:
Signature: Title:
STATE OF FLORIDA
❑ COLLIER COUNTY ❑ LEE COUNTY
Sworn to and Subscribed Before Me, a Notary Public,for the above State and County, on this Day
of , 20
Notary Public
My Commission Expires:
(AFFIX OFFICIAL SEAL)
#13-6018 29
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Co ier County
Administrative Services Division
Purchasing
Attachment 5: Vendor Submittal—immigration Affidavit
Solicitation: 13-6018—Fasteners and Wheel Weights
This Affidavit is required and should be signed, notarized by an authorized principal of the firm and submitted with formal
Invitations to Bid (ITB's)and Request for Proposals(RFP)submittals. Further, Vendors/ Bidders are required to enroll
in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the
vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company
Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Failure to
include this Affidavit and acceptable evidence of enrollment in the E-Verify program, may deem the Vendor I
Bidder's proposal as non-responsive.
Collier County will not intentionally award County contracts to any vendor who knowingly employs unauthorized alien
workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e)Section 274A(e)of
the Immigration and Nationality Act("INA").
Collier County may consider the employment by any vendor of unauthorized aliens a violation of Section 274A(e)of the
INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A(e)of the INA shall be
grounds for unilateral termination of the contract by Collier County.
Vendor attests that they are fully compliant with all applicable immigration laws(specifically to the 1986 Immigration Act
and subsequent Amendment(s))and agrees to comply with the provisions of the Memorandum of Understanding with E-
Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E-Verify), operated by the
Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the
Vendor's/Bidder's proposal.
Company Name Lawson Products, Inc.
Print Name Frank Ziegler Title VP& Chief Compliance
. Officer
Signature Vs.,....g-_SJ f.I�
Date 4/22/13
State of Illinois
County of Cook
The foregoing instrument was signed and acknowledged before me this oi2,t1 day of Ap i II ,2013,by
P / .� / is erSorw,lly k-noWn -to cute.
rank- J . 2/,e'ier who as-identifieetiarr.
(Pri t or Type N ) (Type of identification and Number)
Notary blic Signature
,4�yI� • OFFICIAL SEAL
/ (A.ri.o =5. at.sSir MARIA S CASSIN
Printed Name of Notary Public NOTARYpt -STATE OFIWNOIS
7/ ,4 9(0 /y1 /9t'L dog ��'COMPASSION JRES 05/1W13
Notary Co ission Number/E�C iration
rY P
The signee of this Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of
this affidavit to interrogatories hereinafter made.
#13-6018 30
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co le;Ccmulty
Admirve services D .;..
Purchasing
Attachment 6:Vendor Substitute W—9
Request for Taxpayer Identification Number and Certification
In accordance with the Internal Revenue Service regulations, Collier County is required to collect the following
information for tax reporting purposes from individuals and companies who do business with the County(including
social security numbers if used by the individual or company for tax reporting purposes). Florida Statute
119.071(5) require that the county notify you in writing of the reason for collecting this information, which will be
used for no other purpose than herein stated. Please complete all information that applies to your business and
return with your quote or proposal.
1. General Information(provide all information)
Taxpayer Name Lawson Products,Inc.
(as shown on income tax return)
Business Name
(if different from taxpayer name)
Address 8770 W. Bryn Mawr Ave.,Suite 900 City Chicago
State Illinois Zip_60631-3515
Telephone 773-304-5050 FAX 312-267-1734 Email govsales(E lawsonoroducts.com
Order Information Remit/Payment Information
Address 8770 W.Bryn Mawr Ave.,Suite 900 Address PO Box 809401
Atom
City Chicago State IL Zip 60631-3515 City Chicago State IL Zip 60680-9401
FAX 312-267-1734 FAX 312-278-0785
Email oovsales(c�lawsoni roducts.com Email
2. Company Status(check only one)
_ Individual/Sole Proprietor X Corporation _Partnership
Tax Exempt(Federal income tax-exempt entity _Limited Liability Company
under Internal Revenue Service guidelines IRC
501 (c)3) C Enter the tax classification
(D=Disregarded Entity, C=Corporation, P=Partnership)
3. Taxpayer Identification Number(for tax reporting purposes only)
Federal Tax Identification Number(TIN) 80-0496603
(Vendors who do not have a TIN,will be required to provide a social security number prior to an award of the contract.)
4. Sign and Date Form
Certification:Under penalties of perjury, I certify that the information shown on this form is correct to my knowledge.
Signature Date 4/22/13
Title VP&Chief Compliance Officer Phone Number 773-304-5050
#13-6018 31
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Co ier County
Administrative Services Division
Purchasing
Attachment 7: Vendor Submittal - Insurance and Bonding Requirements
Insurance/Bond Type Required Limits •
1. ®Worker's Statuto ry Limits of Florida Statutes, Chapter 440 and all Federal Government
Compensation Statutory Limits and Requirements
2. E Employer's Liability $500,000 single limit per occurrence
3. E Commercial General Bodily Injury and Property Damage
Liability(Occurrence Form)
patterned after the current $1,000,000 single limit per occurrence, $2,000,000 aggregate for Bodily Injury
ISO form Liability and Property Damage Liability. This shall include Premises and
Operations; Independent Contractors; Products and Completed Operations
and Contractual Liability.
4. E Indemnification To the maximum extent permitted by Florida law, the
Contractor/Vendor/Consultant shall indemnify and hold harmless Collier
County, its officers and employees from any and all liabilities, damages,
losses and costs, including, but not limited to, reasonable attorneys'fees and
paralegals'fees, to the extent caused by the negligence, recklessness, or
intentionally wrongful conduct of the Contractor/Vendor/Consultant or anyone
employed or utilized by the Contractor/Vendor/Consultant in the performance
of this Agreement. This indemnification obligation shall not be construed to
negate, abridge or reduce any other rights or remedies which otherwise may
be available to an indemnified party or person described in this paragraph.
This section does not pertain to any incident arising from the sole negligence
of Collier County.
4. E Automobile Liability $ 1.000,000 Each Occurrence; Bodily Injury& Property Damage,
Owned/Non-owned/Hired;Automobile Included
5. ❑ Other insurance as ❑Watercraft $ Per Occurrence
noted:
El United States Longshoreman's and Harborworker's Act coverage shall be
maintained where applicable to the completion of the work.
$ Per Occurrence
Maritime Coverage(Jones Act)shall be maintained where applicable to
the completion of the work.
$ Per Occurrence
❑Aircraft Liability coverage shall be carried in limits of not less than
$5,000,000 each occurrence if applicable to the completion of the Services
under this Agreement.
$ Per Occurrence
❑ Pollution $ Per Occurrence
❑ Professional Liability $ per claim and in
the aggregate
• $1,000,000 per claim and in the aggregate
• $2,000,000 per claim and in the aggregate
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❑ Project Professional Liability $ Per Occurrence
gym:,
❑Valuable Papers Insurance $ Per Occurrence
6. ❑ Bid bond Shall be submitted with proposal response in the form of certified funds,
cashiers' check or an Irrevocable letter of credit, a cash bond posted with the
County Clerk, or proposal bond in a sum equal to 5% of the cost proposal.All
checks shall be made payable to the Collier County Board of County
Commissioners on a bank or trust company located in the State of Florida and
insured by the Federal Deposit Insurance Corporation.
7. ❑ Performance and For projects in excess of$200,000, bonds shall be submitted with the
Payment Bonds executed contract by Proposers receiving award, and written for 100% of the
Contract award amount, the cost borne by the Proposer receiving an award.
The Performance and Payment Bonds shall be underwritten by a surety
authorized to do business in the State of Florida and otherwise acceptable to
Owner; provided, however,the surety shall be rated as "A-"or better as to
general policy holders rating and Class V or higher rating as to financial size
category and the amount required shall not exceed 5% of the reported policy
holders'surplus, all as reported in the most current Best Key Rating Guide,
published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New
York 10038.
8. ® Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is
required to meet. The same Vendor shall provide County with certificates of insurance meeting the
required insurance provisions.
9. ® Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for
Commercial General Liability where required.
10. It The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board
of County Commissioners in Collier County, OR Collier County Government, OR Collier County. The
Certificates of Insurance must state the Contract Number, or Project Number, or specific Project
description, or must read: For any and all work performed on behalf of Collier County.
11. ® Thirty(30) Days Cancellation Notice required.
Vendor's Insurance Statement
We understand the insurance requirements of these specifications and that the evidence of insurability may
be required within five (5)days of the award of this solicitation.
Name of Firm Lawson Products, Inc. Date 4/22/13
Vendor Signature rtsalC\--s
Print Name Frank Zielger
Insurance Agency Associated Agencies, Inc. & Marsh USA,Inc.
Agent Name Skip Schrayer&Rachel Sementitli Telephone Number 847-427-8400
#13-6018 33
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Vera
a t:cit
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Company 1D Number;640532
THE E-VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION
MEMORANDUM OF UNDERSTANDING
ARTICLE I
PURPOSE AND AUTHORITY
This Memorandum of Understanding (MOU) sets forth the points of agreement between the
Department of Homeland Security (DHS) and Lawson Products. Inc (Employer) regarding the
Employer's participation in the Employment Eligibility Verification Program(E-Verify). This MOU
explains certain features of the E-Verify program and enumerates specific responsibilities of
DHS, the Social Security Administration (SSA), and the Employer. E-Verify is a program that
electronically confirms an employee's eligibility to work in the United States after completion of
the Employment Eligibility Verification Form (Form 1-9). For covered government contractors, E-
Verify is used to verify the employment eligibility of all newly hired employees and all existing
employees assigned. to Federal contracts or to verify the entire workforce if the contractor so
chooses.
Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal Immigration
Reform and Immigrant Responsibility Act of 1996(MIRIRA), Pub. L. 104-208, 110 Stat.3009, as
amended (8 U.S.C. § 1324a note). Authority for use of the E-Verify program by Federal
contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility
Verification", of the Federal Acquisition Regulation(FAR) (hereinafter referred to in this MOU as
a "Federal contractor with the FAR E-Verify clause") to verify the employment eligibility of
certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive
Order 12989,as amended.
ARTICLE iI
FUNCTIONS TO BE PERFORMED
A.RESPONSIBILITIES OF SSA
1. SSA agrees to provide the Employer with available information that allows the Employer to
confirm the accuracy of Social Security Numbers provided by all employees verified under this
MOU and the employment authorization of U.S. citizens.
2. SSA agrees to provide to the Employer appropriate assistance with operational problems that
may arise during the Employer's participation in the E-Verify program. SSA agrees to provide
the Employer with names, titles, addresses, and telephone numbers of SSA representatives to
be contacted during the E-Verify process.
3. SSA agrees to safeguard the information provided by the Employer through the E-Verify
program procedures, and to limit access to such information, as is appropriate by law, to
individuals responsible for the verification of Social Security Numbers and for evaluation of the
E-Verify program or such other persons or entities who may be authorized by SSA as governed
Page 1 of 13 k E-Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify
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.- E-Verify .a,
„w,
Company ID Number:640532
by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA
regulations(20 CFR Part 401).
4. SSA agrees to provide a means of automated verification that is designed(in conjunction with
DHS's automated system if necessary) to provide confirmation or tentative nonconfirmation of
U.S, citizens'employment eligibility within 3 Federal Government work days of the initial inquiry.
5. SSA agrees to provide a means of secondary verification (including updating SSA records as
may be necessary)for employees who contest SSA tentative nonconfirmations that is designed
to provide final confirmation or nonconfirmation of U.S. citizens' employment eligibility and
accuracy of SSA records for both citizens and non-citizens within 10 Federal Government work
days of the date of referral to SSA, unless SSA determines that more than 10 days may be
necessary. In such cases, SSA will provide additional verification instructions.
B.RESPONSIBILITIES OF DHS
1. After SSA verifies the accuracy of SSA records for employees through E-Verify, DHS agrees.
to provide the Employer access to selected data from DHS's database to enable the Employer
to conduct, to the extent authorized by this MOU:
•Automated verification checks on employees by electronic means, and
•Photo verification checks(when available)on employees.
2. DHS agrees to provide to the Employer appropriate assistance with operational problems that
may arise during the Employer's participation in the E-Verify program. OHS agrees to provide
the Employer names, titles, addresses, and telephone numbers of OHS representatives to be
contacted during the E-Verify process.
3. DHS agrees to make available to the Employer at the E-Verlfy Web site and on the E-Verify
Web browser, instructional materials on E-Verify policies, procedures and requirements for both
SSA and DHS, including restrictions on the use of E-Verify. DHS agrees to provide training
materials on E-Verify.
4. DHS agrees to provide to the Employer a notice,which indicates the Employer's participation
in the E-Verify program. OHS also agrees to provide to the Employer anti-discrimination notices
issued by the Office of Special Counsel for Immigration-Related Unfair Employment Practices
(OSC), Civil Rights Division, U.S. Department of Justice.
5. DHS agrees to issue the Employer a user identification number and password that permits
the Employer to verify information provided by employees with DHS's database.
6. OHS agrees to safeguard the information provided to DHS by the Employer, and to limit
access to such information to individuals responsible for the verification of employees'
employment eligibility and for evaluation of the E-Verify program, or to such other persons or
entities as may be authorized by applicable law. information will be used only to verify the
accuracy of Social Security Numbers and employment eligibility, to enforce the Immigration and
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Nationality Act (INA) and Federal criminal laws, and to administer Federal contracting
requirements.
7. OHS agrees to provide a means of automated verification that is designed (in conjunction
with SSA verification procedures) to provide confirmation or tentative nonconfirmation of
employees'employment eligibility within 3 Federal Government work days of the initial inquiry.
8. DHS agrees to provide a means of secondary verification(including updating OHS records as
may be necessary) for employees who contest DHS tentative nonconfirrnations and photo nonce
match tentative nonconfirmations that is designed to provide final confirmation or
nonconfirmation of the employees' employment eligibility within 10 Federal Government work
days of the date of referral to OHS, unless OHS determines that more than 10 days may be
necessary. In such cases, DHS will provide additional verification instructions. .
C.RESPONSIBILITIES OF THE EMPLOYER •: .,v.° <.,.-!1',.-& <. ' t-•. :-;;�
1. The Employer agrees to display the notices supplied by DHS in a prominent place that is
clearly visible to prospective employees and all employees who are to be verified through the
system. ..
2. The Employer agrees to provide to the SSA and DHS the names, titles, addresses, and
telephone numbers of the Employer representatives to be contacted regarding E-Verify.
3. The Employer agrees to become familiar with and comply with the most recent version of the
E-Verify User Manual.
4. The Employer agrees that any Employer Representative who will perform employment
verification queries will complete the E-Verify Tutorial before that individual initiates any queries.
A.The Employer agrees that all Employer representatives will take the refresher tutorials
initiated by the E-Verify program as a condition of continued use of E-Verify.
B. Failure to complete a refresher tutorial will prevent the Employer from continued use
of the program.
5.The Employer agrees to comply with current Form 1-9 procedures,with two exceptions:
• If an employee presents a"List B"identity document,the Employer agrees to only
accept"List B"documents that
contain a photo. (List B documents identified in 8 C.F.R.§274a.2(b)(1)(B))can be
presented during the Form 1-9
process to establish identity.) If an employee objects to the photo requirement for
religious reasons,the Employer
should contact E-Verify at 888-464-4218.
• If an employee presents a DHS Form 1-551 (Permanent Resident Card)or Form 1-766
(Employment Authorization Document)to complete the Form 1-9,the Employer agrees to
make a photocopy of the document and to retain the photocopy with the employee's
Form 1-9.The photocopy must be of sufficient quality to allow for verification of the photo
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Company ID Number:640532
and written.information. The employer will use the photocopy to verify the photo and to
assist DHS with its review of photo non-matches that are contested by employees. Note
that employees retain the right to present any List A, or List B and List C, documentation
to complete the Form 1-9. DHS may in the future designate other documents that
activate the photo screening tool.
6. The Employer understands that participation in E-Verify does not exempt the Employer from
the responsibility to complete, retain, and make available for inspection Forms 1-9 that relate to
its employees, or from other requirements of applicable regulations or laws; including the
obligation to comply with the antidiscrimination requirements of section 274E of the INA with
respect to Form 1-9 procedures, except for the following modified requirements applicable by
reason of the Employer's participation In E-Verify: (1) identity documents must have photos, as
described in paragraph 5 above; (2) a rebuttable presumption,is established that the Employer
has not violated section 274A(a)(1)(A) of the Immigration and Nationality Act(INA) with respect
to the hiring of any individual If it obtains confirmation of the<identity.andem
the individual in good faith compliance with the terms and conditions of E VVeiify; ibtiitt of
Employer must notify OHS if it continues to employ any employee after receiving (a�fnal
nonconfirmation, and is subject to a civil money penalty between -$550 and $1,100 for each
failure to notify DHS of continued employment following a final nonconfirmation; (4) the
Employer is subject to a rebuttable presumption that It has knowingly employed an unauthorized
alien in violation of section 274A(a)(1)(A)if the Employer continues to employ an employee after
receiving a final nonconfirmation; and (5) no person or entity
criminally liable under any law for any action taken in goo faith basednonf information is provided
through the confirmation system. OHS reserves the right to .conduct Form 1-9 and E-Verify
system compliance inspections during the course of E-Verify, as well as to conduct any other
enforcement activity authorized by law.
7. The Employer agrees to initiate E-Verify verification procedures for new employees within 3
Employer business days after each employee has been hired (but after the Form 1-9 has been
completed), and to complete as many (but only as many) steps of the E-Verify process as are
necessary according to the E-Verify User Manual, or in the case of Federal contractors with the
FAR E-Verify clause, the E-Verify User Manual for Federal Contractors. The Employer is
prohibited from initiating verification procedures before the employee has been hired and the
Form 1-9 completed. If the automated system to be queried is temporarily unavailable, the 3-day
time period is extended until it is again operational in order to accommodate the Employer's
attempting, in good faith, to make inquiries during the period of unavailability. Employers may
initiate verification by notating the Form 1-9 in circumstances where the employee has applied
for a Social Security Number (SSN) from the SSA and is waiting to receive the SSN, provided
that the Employer performs an E Verify employment verification query using the employee's
SSN as soon as the SSN becomes available.
8. The Employer agrees not to use E-Verify procedures for pre-employment screening of job
applicants, in support of any unlawful employment practice, or for any other use not authorized
by this MOU. Employers must use E-Verify for all new employees, unless an Employer is a
Federal contractor that qualifies for the exceptions described in Article 11.0.1.c. Except as
provided in Article 11.0, the Employer will not verify selectively and will not verify employees
hired before the effective date of this MOU. The Employer understands that if the Employer
uses the E-Verify system for any purpose other than as authorized by this MOU, the Employer
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•
Company ID Number 640632
may be subject to appropriate legal action and termination of its access to SSA and DHS
information pursuant to this MOU.
9. The Employer agrees to follow appropriate procedures (see Article ill. below) regarding
tentative nonconfirmations, including notifying employees in private of the finding and providing
them written notice of the findings, providing written referral instructions to employees, allowing
employees to contest the finding, and not taking adverse action against employees if they
choose to contest the finding. Further, when employees contest a tentative nonconfirmation
based upon a photo non-match, the Employer is required to take affirmative steps (see Article
IIt.B. below)to contact DHS with information necessary to resolve the challenge.
10.The Employer agrees not to take any adverse action against an employee based upon the
employee's perceived employment eligibility status while SSA or DHS is processing the
verification request unless the Employer obtains knowledge.(as defined in 8 C.F.R, § 274a.1(l))
that the employee is not work authorized. The Employer understands:that•an initial inability of
the SSA or DHS automated verification system to verify work authorization, a tentative
nonconfirmation, a case in continuance (indicating the need for additional time for the
government to resolve a case), or the finding of a photo non-match, does not establish, and
should not be interpreted as evidence, that the employee is not work,authorized. In any of the
cases listed above, the employee must be provided a full and fair opportunity to contest the
finding, and If he or she does so, the employee may not be terminated or suffer any adverse
employment consequences based upon the employee's perceived employment-eligibility status
(including denying, reducing, or extending work hours, delaying or preventing training, requiring
an employee to work in poorer conditions, refusing to assign the employee to a Federal contract
or other assignment, or otherwise subjecting an employee to any assumption that he or she is
unauthorized to work) until and unless secondary verification by SSA or DHS has been
completed and a final nonconfirmation has been issued. If the employee does not choose to
contest a tentative nonconfirmation or a photo non-match or if a secondary verification is
completed and a final nonconfirmation is issued,then the Employer can find the employee is not
work authorized and terminate the employee's employment. Employers or employees with
questions about a final nonconfirmation may call E-Verify at 1-888-464-4218 or OSC at 1-800-
255-8155 or 1-800-237-2515(TDD).
1 i. The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section
274B of the INA, as applicable, by not discriminating unlawfully against any individual in hiring,
firing, or recruitment or referral practices because of his or her national origin or, in the case of a
protected individual as defined in section 274B(a)(3) of the INA, because of his or her
citizenship status. The Employer understands that such illegal practices can include selective
verification or use of E-Verify except as provided in part D below, or discharging or refusing to
hire employees because they appear or sound "foreign" or have received tentative
nonconfirmations. The Employer further understands that any violation of the unfair immigration-
related employment practices provisions in section 274B of the INA could subject the Employer
to civil penalties, back pay awards, and other sanctions, and violations of Title VII could subject
the Employer to back pay awards, compensatory and punitive damages. Violations of either
section 274B of the INA or Title VII may also lead to the termination of its participation in E-
Verify. If the Employer has any questions relating to the anti-discrimination provision, it should
contact OSC at 1-800-255-8155 or 1-800-237-2515(TDD).
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12. The Employer agrees to record the case verification number on the employee's Form 1-9 or
to print the screen containing the case verification number and attach it to the employee's Form
1-9.
13. The Employer agrees that it will use the information it receives from SSA or OHS pursuant
to E-Verify and this MOU only to confirm the employment eligibility of employees as authorized
by this MOU. The Employer agrees that it will safeguard this information, and means of access
to it(such as PINS and passwords)to ensure that It is not used for any other purpose and as
necessary to protect its confidentiality, including ensuring that it is not disseminated to any
person other than employees of the Employer who are authorized to perform the Employer's
responsibilities under this MOU,except for such dissemination as may be authorized in advance
by SSA or DHS for legitimate purposes.
14. The Employer acknowledges that the information which it receives from SSA is governed by
the Privacy Act(5 U.S.C. § 552a(1)(1) and(3)) and the Social Security Act(42 U.S.C. 1308(a)),
and that any person who obtains this information under false pretenses or uses it for any
purpose other than as provided for in this MOU may be subject to criminal penalties.
15. The Employer agrees to cooperate with DHS and SSA in their compliance monitoring and
evaluation of E-Verify, including by permitting OHS and SSA, upon reasonable notice,to review
Forms 1-9 and other employment records and to interview it and its employees regarding the
Employer's use of E-Verify, and to respond in a timely and accurate manner to OHS requests
for information relating to their participation in E-Verify.
D.RESPONSIBILITIES OF FEDERAL CONTRACTORS WITH THE FAR E-VERIFY CLAUSE
1. The Employer understands that if it is a subject to the employment verification terms
in Subpart 22.18 of the FAR, it must verify the employment eligibility of any existing employee
assigned to the contract and all new hires, as discussed in the Supplemental Guide for Federal
Contractors, Once an employee has been verified through E-Verify by the Employer, the
Employer may not reverify the employee through E-Verity.
a. Federal contractors with the FAR E-Verify clause agree to become familiar with and
comply with the most recent versions of the E-Verify User Manual for Federal Contractors and
the E-Verify Supplemental Guide for Federal Contractors.
b. Federal contractors with the FAR E-Verify clause agree to complete a tutorial for
Federal contractors with the FAR E-Verify clause.
c. Federal contractors with the FAR E-Verify clause not enrolled at the time of contract
award: An Employer that is not enrolled in E-Verify at the time of a contract award must enroll
as a Federal contractor with the FAR E-Verify clause in E-Verify within 30 calendar days of
contract award and, within 90 days of enrollment, begin to use E-Verify to initiate verification of
employment eligibility of new hires of the Employer who are working in the United States,
whether or not assigned to the contract. Once the Employer begins verifying new hires, such
verification of new hires must be initiated within 3 business days after the date of hire. Once
enrolled in E-Verify as a Federal contractor with the FAR E-Verify clause, the Employer must
initiate verification of employees assigned to the contract within 90 calendar days from the time
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Company ID Number.640532
of enrollment in the system and after the date and selecting which employees will be verified in
E-Verify or within 30 days of an employee's assignment to the contract,whichever date is later.
d. Employers that are already enrolled in E-Verify at the time of a contract award but are
not enrolled in the system as a Federal contractor with the FAR E-Verify clause: Employers
enrolled in E-Verify for 90 days or more at the time of a contract award must use E-Verify to
initiate verification of employment eligibility for new hires of the Employer who are working in the
United States, whether or not assigned to the contract,within 3 business days after the date of
hire. Employers enrolled in E-Verify as other than a Federal contractor with the FAR'E-Verify
clause, must update E-Verify to indicate that they are a Federal contractor with the FAR E-
Verify clause within 30 days after assignment to the contract. If the Employer is enrolled in E-
Verify for 90 calendar days or less at the time of contract award, the Employer must, within 90
days of enrollment, begin to use E-Verify to initiate verification of new hires of the contractor
who are working in the United States, whether or not assigned to the contract.Such verification
of new hires must be initiated within 3 business days after:-the--date.of'hire. An Employer
enrolled as a Federal contractor with the FAR E-Verify clause in E-Verify must initiate
verification of each employee assigned to the contract within 90 calendar.days, after date of
contract award or within 30 days after assignment to the contract,whichever is later.
e. Institutions of higher education, State, local and tribal governments and sureties:
Federal contractors with the FAR E-Verify clause that are institutions of higher-education (as
defined at 20 U.S.C. 1001(a)), State or local governments, governments of Federally recognized
Indian tribes, or sureties performing under a takeover agreement entered into with a Federal
agency pursuant to a performance bond may choose to only verify new and existing employees
assigned to the Federal contract. Such Federal contractors with.-the'FAR:E-Verify clause may;
however, elect to verify all new hires, and/or all existing employees hired after November 6,
1986. The provisions of Article II.D, paragraphs 1.a and 1.b of this MOU providing timeframes
for initiating employment verification of employees assigned to a contract apply to such
institutions of higher education, State, local and tribal governments, and sureties.
f. Verification of all employees: Upon enrollment, Employers who are Federal contractors
with the FAR E-Verify clause may elect to verify employment eligibility of all existing employees
working in the United States who were hired after November 6, 1986, instead of verifying only
new employees and those existing employees assigned to a covered Federal contract. After
enrollment, Employers must elect to do so only in the manner designated by OHS and initiate E-
Verify verification of all existing employees within 180 days after the election.
g. Form 1-9 procedures for existing employees of Federal contractors with the FAR E-
Verify clause: Federal contractors with the FAR E-Verify clause may choose to complete new
Forms 1-9 for all existing employees other than those that are completely exempt from this
process. Federal contractors with the FAR E-Verify clause may also update previously
completed Forms 1-9 to initiate E-Verify verification of existing employees who are not
completely exempt as long as that Form 1-9 is complete (including the SSN), complies with
Article II,C.5, the employee's work authorization has not expired, and the Employer has
reviewed the information reflected in the Form 1-9 either in person or in communications with the
employee to ensure that the employee's stated basis in section 1 of the Form 1-9 for work
authorization has not changed (including, but not limited to, a lawful permanent resident alien
having become a naturalized U.S, citizen). If the Employer is unable to determine that the Form
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Vern „ esAa4,
Company ID Number:640532
1-9 complies with Article II.C.5, if the employee's basis for work authorization as attested in.
section 1 has expired or changed, or if the Form 1-9 contains no SSN or is otherwise incomplete,
the Employer shall complete a new 1-9 consistent with Article II.C.5, or update the previous 1-9
to provide the necessary information. If section 1 of the Form 1-9 is otherwise valid and up-to-
date and the form otherwise complies with Article II.C.5, but reflects documentation (such as a
U.S. passport or Form 1-551) that expired subsequent to completion of the Form 1-9, the
Employer shall not require the production of additional documentation, or use the photo
screening tool described in Article I1.C.5, subject to any additional or superseding Instructions
that may be provided on this subject in the Supplemental Guide for Federal Contractors. -
Nothing in this section shall be construed to require a second verification using E-Verify of any
assigned employee who has previously been verified as a newly hired employee under this
MOO, or to authorize verification of any existing employee by any Employer that is not a Federal
contractor with the FAR E-Verify clause.
2. The Employer understands that if it is a Federal contractor.with the FARE-Verify clause, its
compliance with this MOU is a performance requirement under the terms of the Federal
contract or subcontract, and the Employer consents to the release of information relating to
compliance with its verification responsibilities under this MOU to contracting officers or other
officials authorized to review the Employer's compliance with Federal contracting requirements.
ARTICLE CLE Iii
REFERRAL OF INDIVIDUALS TO SSA.AND DHS
A. REFERRAL TO SSA
1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must print
the notice as directed by the E-Verify system and provide it to the employee so that the
employee may determine whether he or she will contest the tentative nonconfirmation. The
Employer must review the tentative nonconfirmation with the employee in private.
2. The Employer will refer employees to SSA field offices only as directed by the automated
system based on a tentative nonconfirmation, and only after the Employer records the case
verification number, reviews the input to detect any transaction errors, and determines that the
employee contests the tentative nonconfirmation.The Employer will transmit the Social Security
Number to SSA for verification again if this review indicates a need to do so. The Employer will
determine whether the employee contests the tentative nonconfirmation as soon as possible
after the Employer receives it.
3. If the employee contests an SSA tentative nonconfirmation,the Employer will provide the
employee with a system-generated referral letter and instruct the employee to visit an SSA
office within 8 Federal Government work days. SSA will electronically transmit the result of the
referral to the Employer within 10 Federal Government work days of the referral unless it
determines that more than 10 days is necessary. The Employer agrees to check the E-Verify
system regularly for case updates.
4. The Employer agrees not to ask the employee to obtain a printout from the Social Security
Number database (the Numident) or other written verification of the Social Security Number
from the SSA.
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EVenlyi
Company ID Number:640532
B.REFERRAL TO DHS
1. if the Employer receives a tentative nonconfirmation issued by OHS, the Employer must print
the tentative nonconfirmation notice as directed by the E-Verify system and provide It to the
employee so that the employee may determine whether he or she will contest the tentative
nonconfirmation. The Employer must review the tentative nonconfirmation with the employee in
private. •
•
2. If the Employer finds a photo non-match for an employee who provides a document for which
the automated system has transmitted a photo, the employer must print the photo non-match
tentative nonconfirrnation notice as directed by the automated system and provide it to the
employee so that the employee may determine whether he or.she will contest the finding. The
Employer must review the tentative nonconfirmation with the employee in private.
3. The Employer agrees to refer individuals to DHS only when the employee chooses,to•contest
a tentative nonconfirmation received from DHS automated verification process or when the
Employer issues a tentative nonconfirmation based upon a photo non-match. The Employer will
determine whether the employee contests the tentative nonconfirmation as soon as possible
after the Employer receives it
•
4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer will
provide the employee with a referral letter and instruct the employee to contact DHS"through'its..
toll-free hotline(as found on the referral letter)within 8 Federal Government work days.
5. If the employee contests a tentative nonconfirmation based upon a photo non-match,the
Employer will provide the employee with a referral letter to OHS. DHS will electronically transmit
the result of the referral to the Employer within 10 Federal Government work days of the referral
unless it determines that more than 10 days is necessary. The Employer agrees to check the E-
Verify system regularly for case updates.
6.The Employer agrees that if an employee contests a tentative nonconfirmation based upon a
photo non-match,the Employer will send a copy of the employee's Form 1-551 or Form 1-766 to
DHS for review by:
•Scanning and uploading the document, or
• Sending a photocopy of the document by an express mail account(paid for at
employer expense).
T. If the Employer determines that there is a photo non-match when comparing the photocopied
List B document described in Article II.C.5 with the image generated in E-Verify,the Employer
must forward the employee's documentation to OHS using one of the means described in the
preceding paragraph, and allow OHS to resolve the case.
ARTICLE IV
SERVICE PROVISIONS
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EVerUyWN4
Company ID Number:640532
SSA and DHS will not charge the Employer for verification services performed under this MOU.
The Employer is responsible for providing equipment needed to make inquiries. To access E-
Verify, an Employer will need a personal computer with Internet access.
ARTICLE V
PARTIES
A.This MOU is effective upon the signature of all parties, and shall continue in effect for as long
as the SSA and DHS conduct the E-Verify program unless modified in writing by the mutual
consent of all parties, or terminated by any party upon 30 days prior written notice to the others.
Any and all system enhancements to the E-Verify program by DHS or SSA, including but not
limited to the E-Verify checking against additional data sources and instituting new verification
procedures, will be covered under this MOU and will not cause the need for a supplemental
MOU that outlines these changes. DHS agrees to train employers on all changes-made to E-
Verify through the use of mandatory refresher tutorials and updates,to the E-Verify User
Manual, the E-Verify User Manual for Federal Contractors or the E-Verify Supplemental Guide
for Federal Contractors. Even without changes to E-Verify, DHS reserves the right to require
employers to take mandatory refresher tutorials. An Employer that is a Federal contractor with
the FAR E-Verify clause may terminate this MOU when the Federal contract that requires its
participation in E-Verify is terminated or completed. In such a circumstance, the Federal
contractor with the FAR E-Verify clause must provide written notice to DHS. an Employer that
is a Federal contractor with the FAR E-Verify clause fails to provide such notice, that Employer
will remain a participant in the E-Verify program, will remain bound by the terms of this MOU
that apply to participants that are not Federal contractors with the FAR E-Verify clause, and will
be required to use the E-Verify procedures to verify the employment eligibility of all newly hired
employees.
B. Notwithstanding Article V, part A of this MOU, DHS may terminate this MOU if deemed
necessary because of the requirements of law or policy, or upon a determination by SSA or
DHS that there has been a breach of system integrity or security by the Employer, or a failure
on the part of the Employer to comply with established procedures or legal requirements. The
Employer understands that if it is a Federal contractor with the FAR E-Verify clause,termination
of this MOU by any party for any reason may negatively affect its performance of its contractual
responsibilities.
C. Some or all SSA and DHS responsibilities under this MOU may be performed by
contractor(s), and SSA and DHS may adjust verification responsibilities between each other as
they may determine necessary. By separate agreement with DHS, SSA has agreed to perform
its responsibilities as described in this MOU,
D. Nothing in this MOU is intended, or should be construed, to create any right or benefit,
substantive or procedural, enforceable at law by any third party against the United States, its
agencies, officers, or employees, or against the Employer, its agents,officers,or employees.
E. Each party shall be solely responsible for defending any claim or action against it arising out
of or related to E-Verify or this MOU, whether civil or criminal, and for any liability wherefrom,
including (but not limited to) any dispute between the Employer and any other person or entity
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" 1
i... J why„..* ,,
,..„,: yr. _Company ID Number:640532
regarding the applicability of Section 403(d) of IIRIRA to any action taken or allegedly taken by
the Employer.
F. The Employer understands that the fact of its participation in E-Verify is not confidential
information and may be disclosed as authorized or required by law and DHS or SSA policy,
including but not limited to, Congressional oversight, E-Verify publicity and media inquiries,
determinations of compliance with Federal contractual requirements, and responses to inquiries
under the Freedom of information Act(FOIA).
G. The foregoing constitutes the full agreement on this subject between DHS and the Employer.
H. The individuals whose signatures appear below represent that they are authorized to enter
into this MOU on behalf of the Employer and DHS respectively..
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March 16, 2010 f , -r
FLORIDA DEPARTMENT OF STATE
LAWSON PRODUCTS, INC. DnmxanofC.aposs
1666 E. TOUSY AVE.
DES PLAINES, IL 60018
Qualification documents for LAWSON PRODUCTS, INC. were filed on
March 15, 2010 and assigned document number F10000001502. Please refer to
this number whenever corresponding with this office.
Your corporation is now qualified and authorized to transact business in
Florida as of the file date.
This document was electronically received and filed under FAX audit number
B10000058807.
A corporation annual report/uniform business report will be due this
office between January 1 and May 1 of the year following the calendar year
of the file date. A Federal Employer Identification (PSI) number will be
required before this report can be filed. If you do not already have an
PEI number, please apply NOW with the Internal Revenue by calling
1-800-829-4933 and requesting form 351-4.
Please be aware if the corporate address changes, it is the responsibility
of the corporation to notify this office.
Should you have any questions regarding this matter, please contact this
office at (050) 245-6995.
Wanda_ Cunningham. ........_.. ......
Regulatory Specialist II
New Filing Section
Division of Corporations Letter Number: 93.0A00006439
P.O Box 6327-Tallahassee,Ronda 32314
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. .
11100000588073
ANIMA/10N BY MEM CORPORATION PORAVITIORIZATION TO TRANSACI. ,
RVIIIMISS IN FLORIDA .
11102DRAPORINGW' CORPC61270117027tenderWMAWN— RilliMar— OFPLORTDA.—- .
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H100000588073
12. Nano and business addresses of offteacs anWor directors:
A. DIRECTORS
cabmen: Ploasesee Exhibit A attached hereto
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H10000058807 3
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H10000058807 3
EXHIBIT A •
TO
STATE OF FLORIDA
APPLICATION BY FOREIGN CORPORATION FOR
.ATI0 1 TO TRACT B .IN_FLORIA_
item Nom. I2A and 12.B. The Mowing are the names and addresses of the officers and
of Lawson Products,Inc.:
CORPORATE OPF15
Tit Nan 4
Proddeenand Cldeflueentive Officer Menus J.Nai 3666 R.Today Avenue,Des PWnes,11.60018
&eeutive Vice President end Reny Doohe)1l 1666 B.T baby Avetaae,Des Plaines,Q.60018
Chief Oman;Otlioer
ExeCut ve•Vies Prodded,Swamp Neil Weakly 1666 L Touhy Avenue,Dee Plaines,IL 60018
sad Omni Carnet
Studer Vim President,!armadas Robert Border 166611.Tacky Avenue,Des Planes,IL 60018
Technology
Seder Vice Prodders;Stnstegia Stewart Howley 1666 E.'Araby Avenue,Des Plaitaes,1.60018
Bedew Bookworms
Seder Vice Pneldent and Ronald Jtnutson 166613.Tacky Avenue,Des Plaines,IL 60018
ChierIrmaill Meer .
Spy Mee Prodded,Operations and Mohelle Ruaaell 16660.Touhy Avenue,Des Plaines,R.60018
Supply Chain hfenagement
Senior Vlos Presidetd, May Elm Sehopp 1666 U.Touhy Avenue,Des Plaines,1L 6001E ,
Hum Resumes
Vioat Residua,Camilar Victor G.aslwz 3666 L Toully Avenue,Des Plaiaes,11.60018
Viol Peendeat,Tamura Valliant Holmes 1666 E.TOuhy Avenue,Des Phdaes,IL 60018
Vice Prestdeat,Phnom Micheal Tonsil 1666 L Tbaby Avatars,Ds Plaines,8.60018
Vice Prestd:at and Counsel,Chat PrankJ.Ziegler 1666 IL Touhy Avenue,Des Plabtes,1.60018
Coeaplierun Nicer and denetary
Vice huddler,Customer d avicc and Lied Abrahamson 1666 E.Touby Avenue,Des Plaines,IL 60018
OnidSshe
Vice Meld:*Sofa George a Buckingham 1666 E.Tuohy Avenue,Des Places,U.60018
Vice Pnaidest.Sales Allen Jacobsen 16668.Toby Avetus,Des PIsines,IL 6001$
Via Pcuideat,Malastteg Lisa Kaplan 1666 E.Touby Avenw,Des Pialau,IL 60018
Vice Padden,National Accounts Shoo Libby 1666 E.Dolby Avenue,Des Planes,IL 60018
Vier President,Logistta and Shone McCarthy 1666 S Tacky Averse.Da Maims.11.60018
Vice President,Supply Menegan ent Patrick Poole 166613.'May Avenue,Des Noises,IL 60018
Vice Peaaldeat,gales Plaaadh and RobertTluibat 1666 B.Tally Avenue,Des Plaines,U.600111
Vida President.Sales Rick%dace 1666 E,TardiyAvenue,Des Pleiaos,U.600111
Vice p Product M Outatlsa WIhia t 1664E.?ashy Avenue,Des Phnom 1L600i$
•
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Ronald R.Pert,M.D.(Choir) 1666 B.Touby Avarua,Des PWnes,11,60018
Tboenes L Ned 16668.Took/Avenue,Des Plaines,,U.60018
ancoaimoaa � .. .
H10000058807 3
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H 10000058807 3
File Number 6670-627-3
I ill_ Treij__
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To all to whom these Presents Shall Come, Greeting:
I,Jesse White, Secretary of State of the State of Illinois, do
hereby certify that
LAWSON PRODUCTS,INC.,A DOMESTIC CORPORATION,INCORPORATED UNDER THE
LAWS OF THIS STATE ON OCTOBER 21,2009,APPEARS TO HAVE COMPLIED WITH ALL
THE PROVISIONS OF THE BUSINESS CORPORATION ACT OF THIS STATE RELATING TO
THE PAYMENT OF FRANCHISE TAXES,AND AS OF THIS DATE,IS IN GOOD STANDING ,
AS A DOMESTIC CORPORATION IN THE STATE OF ILLINOIS.
In Testimony Whereof, I hereto set
`' ;: my hand and cause to be affixed the Great Seal of
( ,. the State of Illinois,this 15TH
Y day of MARCH A.D. 2010
.'.; t1'Y ti ' 1
Ackwileelon 1:woman Cht.ote•do4E40. )1(i)tio I
SIC PlySN YwAybefQtivelenalsoan SECRETARY CO STATE
H10000058807 3 _ - .......
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2013 FOREIGN PROFIT CORPORATION ANNUAL REPORT FILED
DOCUMENT#F10000001302 Apr 08, 2013
Entity Name: LAWSON PRODUCTS, INC. Secretary of State
Current Principal Place of Business:
8770 W.BRYN MAWR AVENUE
SUITE 900
CHICAGO, IL 60631
Current Mailing Address:
8770 W. BRYN MAWR AVENUE
SUITE 900
CHICAGO, IL 60631 US
FEI Number:80-0496603 Certificate of Status Desired: No
Name and Address of Current Registered Agent:
C T CORPORATION SYSTEM
1200 SOUTH PINE ISLAND ROAD
PLANTATION,FL 33324 US
The above named entity submits this statement for the purpose of changing Its registered office or registered agent,or both,in the State of Florida.
SIGNATURE:
Electronic Signature of Registered Agent Date
Officer/Director Detail Detail :
Title PRESIDENT AND CEO Title SR.VICE PRESIDENT,FINANCE;
TREASURER AND CONTROLLER
Name DECATA,MICHAEL G
Name TUVELL,MICHAEL
Address 8770 W.BRYN MAWR AVENUE
SUITE 900 Address 8770 W.BRYN MAWR AVENUE
SUITE 900
City-State-Zip: CHICAGO IL 60631
City-State-Zip: CHICAGO IL 60631
Title EVP,SECRETARY
Title CIO
Name JENKINS,NEIL E
Name BORDER,ROBERT
Address 8770 W.BRYN MAWR AVENUE
SUITE 900 Address 8770 W.BRYN MAWR AVENUE
SUITE 900
City-State-Zip: CHICAGO IL 60631
City-State-Zip: CHICAGO IL 60631
Title VCFO
Name KNUTSON,RONALD
Address 8770 W.BRYN MAWR AVENUE
SUITE 900
City-State-Zip: CHICAGO IL 60631
I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under
oath;that lam an officer or director of the corporation or the receiver or austere empowered to execute this report as required by Chapter 607,Florida Statutes;and that my name appears
above,or on an attachment weft all other like empowered.
SIGNATURE:NEIL E. JENKINS EVP, SECRETARY 04/08/2013
Electronic Signature of Signing Officer/Director Detail Date
Packet Page-2296-
5/28/2013 16.E.2.
2013 FOREIGN PROFIT CORPORATION ANNUAL REPORT FLED
DOCUMENT# F10000001302 Apr 08, 2013
Entity Name: LAWSON PRODUCTS, INC. Secretary of State
Current Principal Place of Business:
8770 W.BRYN MAWR AVENUE
SUITE 900
CHICAGO, IL 60631
Current Mailing Address:
8770 W. BRYN MAWR AVENUE
SUITE 900
CHICAGO, IL 60631 US
FEI Number: 80-0496603 Certificate of Status Desired: No
Name and Address of Current Registered Agent:
C T CORPORATION SYSTEM
1200 SOUTH PINE ISLAND ROAD
PLANTATION,FL 33324 US
The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida.
SIGNATURE:
Electronic Signature of Registered Agent Date
Officer/Director Detail Detail:
Title PRESIDENT AND CEO Title SR.VICE PRESIDENT,FINANCE;
Name DECATA,MICHAEL G TREASURER AND CONTROLLER
Address 8770 W.BRYN MAWR AVENUE Name TUVELL,MICHAEL
SUITE 900 Address 8770 W.BRYN MAWR AVENUE
City-State-Zip: CHICAGO IL 60631 SUITE 900
City-State-Zip: CHICAGO IL 60631
Title EVP,SECRETARY
Name JENKINS,NEIL E Title CIO
Address 8770 W.BRYN MAWR AVENUE Name BORDER,ROBERT
SUITE 900 Address 8770 W.BRYN MAWR AVENUE
City-State-Zip: CHICAGO IL 60631 SUITE 900
City-State-Zip: CHICAGO IL 60631
Title VCFO
Name KNUTSON,RONALD
Address 8770 W.BRYN MAWR AVENUE
SUITE 900
City-State-Zip: CHICAGO IL 60631
I hereby certify that the information indicated on this wort or supplemental report is true and accurate and that my electronic signature shat have the same legal effect as If made under
oath;that 1 em an officer or director of the corporation orthe receiver or trustee empowered to execute this report as required by Chapter 607,Florida Statutes and that my name appears
above,or on an attachment with all other like empowered.
SIGNATURE:NEIL E.JENKINS EVP, SECRETARY 04/08/2013
Electronic Signature of Signing Officer/Director Detail Date
Packet Page-2297-
5/28/2013 16.E.2.
zibiscbunifionliastittiots,
Automotive 43.80%
Cabinets 18.40%
Chemicals 52.30%
Cutting Tools 33.20%
Electrical 68.20%
Fluid Power 54.40%
Fasteners 73.50%
Hand Tools 49.10%
Material Handling 49.10%
Safety 20.50%
Shop Supplies 25.80%
Welding 24.70%
Packet Page-2298-
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Q 7E'll~ Caro Icy Email: adamnorthrup @colliergov.net
Telephone: (239) 252-6098
Administfative Services Division FAX: (239) 252-6302
Purchasing
ADDENDUM #1
Memorandum
Date: April 16, 2013
From: Adam Northrup, Procurement Strategist
To: Interested Bidders
Subject: Addendum # 1
13-6018—Fasteners and Wheel Weights
The following change is issued as an addendum identifying the following change (s) for the
referenced solicitation:
Attachment 8 has been updated to remove duplicated line items and provide
additional explanation of various line items.
If you require additional information please post a question on the Online Bidding site or
contact me using the above contact information.
Please sign below and return a copy of this Addendum with your submittal for the above referenced
solicitation.
4/22/13
fib(Signature) Date
Lawson Products,;Inc.
(Name of Firm)
13-6018
Fasteners and Wheel Weights
Packet Page-2306-
5/28/2013 16.E.2.
Wiif icr
__Couierty Email: adamnorthru collier ov.ne
p@ 9 t
Telephone: (239)252-6098
Administrative Services Division FAX: (239) 252-6302
Purchasing
ADDENDUM #2
Memorandum
Date: April 19, 2013
From: Adam Northrup, Procurement Strategist
To: Interested Bidders
Subject: Addendum #2
13-6018—Fasteners and Wheel Weights
The following change is issued as an addendum identifying the following change (s) for the
referenced solicitation:
Attachment 8 has been updated to correct problems with formulas.
Bid opening date extended by one (1) day to 04/23/2013 at 3:00PM, to allow for
download and completion of corrected Attachment 8.
If you require additional information please post a question on the Online Bidding site or
contact me using the above contact information.
Please sign below and return a copy of this Addendum with your submittal for the above referenced
solicitation.
4/22/13
(Signature) Date
Lawson Products,.inc.
(Name of Firm)
13-6018
Fasteners and Wheel Weights
Packet Page-2307-
5/28/2013 16.E.2.
Co ler County
Administrative services Division
Purchasing
Attachment 2: Vendor's Check List
IMPORTANT: THIS SHEET MUST BE SIGNED BY VENDOR. Please read carefully, sign in the
spaces indicated and return with bid.
Vendor should check off each of the following items as the necessary action is completed:
1. The Bid has been signed.
2. The Bid prices offered have been reviewed.
3. The price extensions and totals have been checked.
4. The payment terms have been indicated.
5. Any required drawings, descriptive literature, etc. have been included.
6. Any delivery information required is included.
7. If reauired, the amount of bid bond has been checked, and the bid bond or cashiers check has
been included.
8. Addendum have been signed and included, if applicable.
9. Affidavit for Claiming Status as a Local Business, if applicable.
10. Immigration Affidavit and company's E-Verify profile page or memorandum of understanding.
11. Copies of licenses, equipment lists, subcontractors or any other information as noted in this
ITB.
12. The mailing envelope must be addressed to:
Purchasing Director
Collier County Government
Purchasing Department
3327 Tamiami Trail E
Naples FL 34112
The mailing envelope must be sealed and marked with:
• Solicitation: 13-6018—Fasteners and Wheel Weights
• Opening Date: 04/22/2013
13. The bid will be mailed or delivered in time to be received no later than the specified opening
date and time. (Otherwise bid cannot be considered.)
ALL COURIER DELIVERED BIDS MUST HAVE THE BID NUMBER AND TITLE ON THE OUTSIDE
OF THE COURIER PACKET.
Lawson Products, Inc.
Comps y Name ^
p 1 Q•
Signature &Title
14\��13
Date
#13-6018 25
Fasteners and Wheel Weights Packet Page-2308-
5/28/2013 16.E.2.
Co der County
Administrative services Division
Purchasing
Attachment 3: Vendor Submittal - Bid Response Form
FROM: Lawson Products, Inc.
Board of County Commissioners
Collier County Government Center
Naples, Florida 34112
RE: Solicitation: 13-6018—Fasteners and Wheel Weights
Dear Commissioners:
The undersigned, as Vendor, hereby declares that the specifications have been fully examined and
the Vendor is fully informed in regard to all conditions pertaining to the work to be performed for as
per the scope of work. The Vendor further declares that the only persons, company or parties
interested in this Bid or the Contract to be entered into as principals are named herein; that this Bid is
made without connection with any other person, company or companies submitting a Bid; and it is all
respects fair and in good faith, without collusion or fraud.
The Vendor proposes and agrees if this Bid is accepted, to contract, either by a County issued
purchase order or formal contract, to comply with the requirements in full in accordance with the
terms, conditions and specifications denoted herein, according to the following unit prices:
1. Percentage Discount from List Price on entire catalog Discounts by Product
Category:
Automotive—47%
Cabinets—23%
Chemicals—55%
Cutting Tools—37%
Electrical—70%
Fluid Power—57%
Fasteners—75%
Hand Tools— 52%
Material Handling—52%
Safety—25%
Shop Supplies—30%
Welding—29%
101.Bid Total 11,506.88
Any discounts or terms must be shown on the Bid Response Form. Such discounts, if any, will be
considered and computed in the tabulation of the bids. In no instance should terms for less than
fifteen (15) days payment be offered.
Prompt Payment Terms: 1 % 10 Days; Net 30 Days ""a
#13-6018
26
Fasteners and Wheel Weights
Packet Page-2309-
5/28/2013 16.E.2.
® Bid Response Form is electronic. Please input line 101. Bid Total, in the online system.
Note: If you choose to bid manually, please submit an ORIGINAL and ONE COPY of your bid
response pages. The undersigned do agree that should this Bid be accepted, to execute a formal
contract, if required, and present the formal contract to the County Purchasing Director for approval
within fifteen (15) days after being notified of an award.
#13-6018 27
Fasteners and Wheel Weights Packet Page-2310-
5/28/2013 16.E.2.
IN WITNESS WHEREOF, WE have hereunto subscribed our names on this 22 day of
April , 2013 in the County of Cook , in the State of Illinois .
Firm's Complete Legal Name Lawson Products, Inc.
Address 8770 W. Bryn Mawr Ave., Suite 900
City, State, Zip Chicago, IL 60631-3515
Florida Certificate of Authority F00000001302
Document Number
Federal Tax Identification 80-0496603
Number
CCR#or CAGE Code 57648
Telephone Number 773-304-5050
FAX Number 312-267-1734
Signature/Title e.,.,.,� ;�.�� A CC 1.&htt ,e c
Type Name of Signature Frank Ziegler
Date 4/22/13
+WF,k******4****,t,t*** *w************i********w.t,t*l`**tot,t********,ak************k***k,F.r*,ti.,t****ir****i **
Additional Contact Information
Send Payments To: (REQUIRED ONLY if different from above)
Firm's Complete Legal Name Lawson Products. Inc.
Address PO Box 809401
City, State, Zip Chicago, IL 60680-9401
Contact Name Brian Carr
Telephone Number 773-304-5219
FAX Number 312-278-0785
Email Address Ardept.usremit{cr�Iawsonproducts.com
#13-6018
28
Fasteners and Wheel Weights
Packet Page-2311-
5/28/2013 16.E.2.
Co frier County
Administrative Services Division
Purchasing
Attachment 4: Vendor Submittal— Local Vendor Preference Affidavit
Solicitation: 13-5018—Fasteners and Wheel Weights(Check Appropriate Boxes Below)
State of Florida(Select County if Vendor is described as a Local Business
o Collier County
❑ Lee County
Vendor affirms that it is a local business as defined by the Purchasing Policy of the Collier County Board of
County Commissioners and the Regulations Thereto. As defined in.Section XI of the Collier County Purchasing
Policy;
A"local business"is defined as a business that has a valid occupational license issued by either Collier or Lee
County for a minimum of one(1)year prior to a Collier County bid or proposal submission that authorizes the
business to provide the commodities or services to be purchased, and a physical business address located
within the limits of Collier or Lee Counties from which the vendor operates or performs business. Post Office
Boxes are not verifiable and shall not be used for the purpose of establishing said physical address. In addition
to the foregoing, a vendor shall not be considered a"local business" unless it contributes to the economic
development and well-being of either Collier or Lee County in a verifiable and measurable way.This may
include, but not be limited to, the retention and expansion of employment opportunities, the support and
increase to either Collier or Lee County's tax base, and residency of employees and principals of the business
within Collier or Lee County. Vendors shall affirm in writing their compliance with the foregoing at the time of
submitting their bid or proposal to be eligible for consideration as a"local business"under this section.
Vendor must complete the following information:
Year Business Established in❑Collier County or Q!Lee County:
Number of Employees (Including Owner(s)or Corporate Officers):
Number of Employees Living in 0 Collier County or❑ Lee (Including Owner(s)or Corporate Officers):
If requested by the County, vendor will be required to provide documentation substantiating the information
given in this affidavit. Failure to do so will result in vendor's submission being deemed not applicable.
Vendor Name: Date:
Address in Collier or Lee County:
Signature: Title:
STATE OF FLORIDA
❑ COLLIER COUNTY ❑ LEE COUNTY
Sworn to and Subscribed Before Me, a Notary Public,for the above State and County, on this Day
of , 20
Notary Public
My Commission Expires:
(AFFIX OFFICIAL SEAL)
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Administrative Setvizes Division
Puirhesrtp
Attachment 5: Vendor Submittal-Immigration Affidavit
Solicitation: 13-6018-Fasteners and Wheel Weights
This Affidavit is required and should be signed, notarized by an authorized principal of the firm and submitted with formal
Invitations to Bid (ITB's)and Request for Proposals(RFP)submittals. Further, Vendors/Bidders are required to enroll
in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the
vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company
Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Failure to
include this Affidavit and acceptable evidence of enrollment in the E-Verify program, may deem the Vendor/
Bidder's proposal as non-responsive.
Collier County will not intentionally award County contracts to any vendor who knowingly employs unauthorized alien
workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e)Section 274A(e)of
the Immigration and Nationality Act("INA").
Collier County may consider the employment by any vendor of unauthorized aliens a violation of Section 274A(e)of the
INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A(e)of the INA shall be
grounds for unilateral termination of the contract by Collier County.
Vendor attests that they are fully compliant with all applicable immigration laws(specifically to the 1986 Immigration Act
and subsequent Amendment(s))and agrees to comply with the provisions of the Memorandum of Understanding with E-
Verify and to provide proof of enrollment in The Employment Eligibility Verification System(E-Verify), operated by the
Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the
Vendor's/Bidder's proposal.
Company Name Lawson Products, Inc.
Print Name Frank Ziegler Title VP& Chief Compliance
,p � � Officer
Signature Tts..,.,.%-Q� 1., t Date 4/22/13
State of Illinois
County of Cook I The foregoing instrument was signed and acknowledged before me this dt2na/day of 421's I ,20 48,by
is ,ersona(� known '-to me,
drank.. 2 - % e� who y as-identifieatien
(Pri t or Type N.n-) (Type of identification and Number)
Notary blic Signature//�� SEAL
f' 4i & off. �+c.ss/rl OFFICIAL SL ASST
Printed Name of Notary Public PUBLIC S CASSIN
-STATE OF ILLINOIS
'Id 9(0 /1? /9,L �O.C..3 W wok 55/1813
Notary Co ission Number/E�Cpiration
The signee of this Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of
this affidavit to interrogatories hereinafter made.
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Administ(9five Services.DMsfon
Purchasing
Attachment 6:Vendor Substitute W—9
Request for Taxpayer Identification Number and Certification
In accordance with the Internal Revenue Service regulations, Collier County is required to collect the following
information for tax reporting purposes from individuals and companies who do business with the County(including
social security numbers if used by the individual or company for tax reporting purposes). Florida Statute
119.071(5) require that the county notify you in writing of the reason for collecting this information, which will be
used for no other purpose than herein stated. Please complete all information that applies to your business and
return with your quote or proposal.
1. General Information(provide all information)
Taxpayer Name Lawson Products.Inc.
(as shown on income tax return)
Business Name
(if different from taxpayer name)
Address 8770 W. Brvn Mawr Ave.,Suite 900 City Chicago
State Illinois Zip_60631-3515
Telephone, 773-304-5050 FAX 312-267-1734 Email govsaleselawsonoroducts.com
Order Information Remit/Payment information
Address 8770 W. Brvn Mawr Ave.,Suite 900 Address PO Box 809401
City Chicago State IL Zip 60631-3515 City Chicago State IL Zip_60680-9401
FAX 312-267-1734 FAX 312-278-0785
Email aovsalesa,lawsonoroducts.com Email
2. Company Status (check only one)
Individual/Sole Proprietor X Corporation __Partnership
_^Tax Exempt(Federal income tax-exempt entity _Limited Liability Company
under Internal Revenue Service guidelines IRC
501 (c)3) C Enter the tax classification
(D=Disregarded Entity, C=Corporation, P=Partnership)
3. Taxpayer Identification Number(for tax reporting purposes only)
Federal Tax Identification Number(TIN) 80-0496603
(Vendors who do not have a TIN,will be required to provide a social security number prior to an award of the contract.)
4. Sign and Date Form
Certification:Under penalties of perjury, 1 certify that the information shown on this form is correct to my knowledge.
Signature a Date 4/22/13
Title VP&Chief Compliance Officer Phone Number 773-304-5050
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Administrative Services Division
Purchasing
Attachment 7: Vendor Submittal - Insurance and Bonding Requirements
Insurance I Bond Type,
1. ®Worker's Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government
Compensation Statutory Limits and Requirements
2. ® Employer's Liability $500.000 single limit per occurrence
3. El Commercial General Bodily Injury and Property Damage
Liability(Occurrence Form)
patterned after the current $1,000.000 single limit per occurrence, $2,000,000 aggregate for Bodily Injury
ISO form Liability and Property Damage Liability. This shall include Premises and
Operations; Independent Contractors; Products and Completed Operations
and Contractual Liability.
4. li4 Indemnification To the maximum extent permitted by Florida law, the
ContractorNendor/Consultant shall indemnify and hold harmless Collier
County, its officers and employees from any and all liabilities, damages,
losses and costs, including, but not limited to, reasonable attorneys'fees and
paralegals'fees, to the extent caused by the negligence, recklessness, or
intentionally wrongful conduct of the Contractor/Vendor/Consultant or anyone
employed or utilized by the Contractor/Vendor/Consultant in the performance
of this Agreement. This indemnification obligation shall not be construed to
negate, abridge or reduce any other rights or remedies which otherwise may
be available to an indemnified party or person described in this paragraph.
This section does not pertain to any incident arising from the sole negligence
of Collier County.
4. ®Automobile Liability $1 000.000 Each Occurrence; Bodily Injury& Property Damage,
Owned/Non-owned/Hired;Automobile Included
5. ❑ Other insurance as ❑Watercraft
noted: $ Per Occurrence
❑ United States Longshoreman's and Harborworker's Act coverage shall be
maintained where applicable to the completion of the work.
$ Per Occurrence
❑Maritime Coverage(Jones Act)shall be maintained where applicable to
the completion of the work.
$ Per Occurrence
❑Aircraft Liability coverage shall be carried in limits of not less than
$5,000,000 each occurrence if applicable to the completion of the Services
under this Agreement.
$ Per Occurrence
❑ Pollution $ Per Occurrence
❑ Professional Liability $ per claim and in
the aggregate
• $1,000,000 per claim and in the aggregate
• $2,000,000 per claim and in the aggregate
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❑ Project Professional Liability $ Per Occurrence
❑ Valuable Papers Insurance $ Per Occurrence
6. ❑ Bid bond Shall be submitted with proposal response in the form of certified funds,
cashiers'check or an irrevocable letter of credit, a cash bond posted with the
County Clerk, or proposal bond in a sum equal to 5%of the cost proposal. All
checks shall be made payable to the Collier County Board of County
Commissioners on a bank or trust company located in the State of Florida and
insured by the Federal.Deposit Insurance Corporation.
7. ❑ Performance and For projects in excess of$200,000, bonds shall be submitted with the
Payment Bonds executed contract by Proposers receiving award, and written for 100% of the
Contract award amount, the cost borne by the Proposer receiving an award.
The Performance and Payment Bonds shall be underwritten by a surety
authorized to do business in the State of Florida and otherwise acceptable to
Owner; provided, however,the surety shall be rated as "A-"or better as to
general policy holders rating and Class V or higher rating as to financial size
category and the amount required shall not exceed 5% of the reported policy
holders'surplus,all as reported in the most current Best Key Rating Guide,
published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New
York 10038.
8. ® Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is
required to meet. The same Vendor shall provide County with certificates of insurance meeting the
required insurance provisions.
9. ® Collier County must be named as "ADDITIONAL, INSURED" on the insurance Certificate for
Commercial General Liability where required.
10. 12g The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board
of County Commissioners in Collier County, OR Collier County Government, OR Collier County. The
Certificates of Insurance must state the Contract Number, or Project Number, or specific Project
description, or must read: For any and all work performed on behalf of Collier County.
11. ® Thirty(30) Days Cancellation Notice required.
Vendor's Insurance Statement
We understand the insurance requirements of these specifications and that the evidence of insurability may
be required within five (5)days of the award of this solicitation.
Name of Firm Lawson Products, Inc. Date 4/22/13
Vendor Signature ....-� �
Print Name Frank Zielger
Insurance Agency Associated Agencies, Inc. &Marsh USA,Inc.
Agent Name Skip Schraver&Rachel Sementitli Telephone Number 847-427-8400
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EVerI1y ~ t
Company ID Number: 640532
THE E-VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION
MEMORANDUM OF UNDERSTANDING
AR TICLE I
PURPOSE AND AUTHORITY
This Memorandum of Understanding (MOU) sets forth the points of agreement between the
Department of Homeland Security (DHS) and Lawson Products. Inc (Employer) regarding the
Employer's participation.In the Employment Eligibility Verification Program(E-Verify). This MOU
explains certain features of the E-Verify program and enumerates specific responsibilities of
DHS, the Social Security Administration (SSA), and the Employer. E-Verify is a program that
electronically confirms an employee's eligibility to work in the United States after completion of
the Employment Eligibility Verification Form (Form 1-9). For covered government contractors, E-
Verify is used to verify the employment eligibility of all newly hired employees and all existing
employees assigned. to Federal contracts or to verify the entire workforce if the contractor so
chooses.
Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal immigration
Reform and Immigrant Responsibility Act of 1996(IIRIRA), Pub. L. 104-208, 110 Stat 3009, as
amended (8 U.S.C. § 1324a note). Authority for use of the E-Verify program by Federal
contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility
Verification", of the Federal Acquisition Regulation(FAR)(hereinafter referred to in this MOU as
a "Federal contractor with the FAR E-Verify clause") to verify the employment eligibility of
certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive
Order 12989, as amended.
ARTS
FUNCTIONS TO BE PERFORMED
A. RESPONSIBILITIES OF SSA
1. SSA agrees to provide the Employer with available information that allows the Employer to
confirm the accuracy of Social Security Numbers provided by all employees verified under this
MOU and the employment authorization of U.S. citizens.
2. SSA agrees to provide to the Employer appropriate assistance with operational problems that
may arise during the Employer's participation in the E-Verify program. SSA agrees to provide
the Employer with names, titles, addresses, and telephone numbers of SSA representatives to
be contacted during the E-Verify process.
3. SSA agrees to safeguard the information provided by the Employer through the E-Verify
program procedures, and to limit access to such information, as is appropriate by law, to
individuals responsible for the verification of Social Security Numbers and for evaluation of the
E-Verify program or such other persons or entities who may be authorized by SSA as governed
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by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA
regulations(20 CFR Part 401).
4. SSA agrees to provide a means of automated verification that is designed(in conjunction with
DHS's automated system if necessary) to provide confirmation or tentative nonconfirmation of
U.S. citizens'employment eligibility within 3 Federal Government work days of the initial inquiry.
5, SSA agrees to provide a means of secondary verification (including updating SSA records as
may be necessary)for employees who contest SSA tentative nonconfirmations that is designed
to provide final confirmation or nonconfirmation of U.S. citizens' employment eligibility and
accuracy of SSA records for both citizens and non-citizens within 10 Federal Government work
days of the date of referral to SSA, unless SSA determines that more than 10 days may be
necessary. In such cases, SSA will provide additional verification instructions.
B.RESPONSIBILITIES OF DHS
•
1. After SSA verifies the accuracy of SSA records for employees through&Verify, DHS agrees
to provide the Employer access to selected data from DHS's database to enable the Employer
to conduct, to the extent authorized by this MOU:
•Automated verification checks on employees by electronic means, and
•Photo verification checks(when available)on employees.
2. DHS agrees to provide to the Employer appropriate assistance with operational problems that
may arise during the Employer's participation in the E-Verify program. DHS agrees to provide
the Employer names, titles, addresses, and telephone numbers of DHS representatives to be
contacted during the E-Verify process.
3. DHS agrees to make available to the Employer at the E-Verify Web site and on the E-Verify
Web browser, instructional materials on E-Verify policies, procedures and requirements for both
SSA and DHS, including restrictions on the use of E-Verify. DHS agrees to provide training
materials on E-Verify.
4. DHS agrees to provide to the Employer a notice,which indicates the Employer's participation
in the E-Verify program. OHS also agrees to provide to the Employer anti-discrimination notices
issued by the Office of Special Counsel for Immigration-Related Unfair Employment Practices
(OSC),Civil Rights Division, U.S.Department of Justice.
5. DHS agrees to issue the Employer a user identification number and password that permits
the Employer to verify information provided by employees with DHS's database.
6. DHS agrees to safeguard the information provided to DHS by the Employer, and to limit
access to such information to individuals responsible for the verification of employees'
employment eligibility and for evaluation of the E-Verify program, or to such other persons or
entities as may be authorized by applicable law. Information will be used only to verify the
accuracy of Social Security Numbers and employment eligibility, to enforce the Immigration and
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Nationality Act (INA) and Federal criminal laws, and to administer Federal contracting
requirements.
7. OHS agrees to provide a means of automated verification that is designed (in conjunction
with SSA verification procedures) to provide confirmation or tentative nonconfirmation of
employees'employment eligibility within 3 Federal Government work days of the initial inquiry.
8. OHS agrees to provide a means of secondary verification(including updating OHS records as
may be necessary) for employees who contest OHS tentative nonconfirmations and photo non-
match tentative nonconfirmations that is designed to provide final confirmation or
nonconfirmation of the employees' employment eligibility within 10 Federal Government work
days of the date of referral to DHS, unless DHS determines that more than 10 days may be
necessary. In such cases, DHS will provide additional verification instructions.
C. RESPONSIBILITIES OF THE EMPLOYER �: ;�-;., . <. '
1. The Employer agrees to display the notices supplied by DHS in a prominent place that is
clearly visible to prospective employees and all employees who are to be verified through the
system.
2. The Employer agrees to provide to the SSA and DHS the names, titles, addresses, and
telephone numbers of the Employer representatives to be contacted regarding E-Verify.
3. The Employer agrees to become familiar with and comply with the most recent version of the
E-Verify User Manual.
4. The Employer agrees that any Employer Representative who will perform employment
verification queries will complete the E-Verify Tutorial before that individual initiates any queries.
A.The Employer agrees that all Employer representatives will take the refresher tutorials
initiated by the E-Verify program as a condition of continued use of E-Verify.
B. Failure to complete a refresher tutorial will prevent the Employer from continued use
of the program.
5.The Employer agrees to comply with current Form 1-9 procedures,with two exceptions:
• If an employee presents a"List B"identity document, the Employer agrees to only
accept"List B"documents that
contain a photo. (List B documents identified in 8 C.F.R.§274a.2(b)(1)(B)) can be
presented during the Form 1-9
process to establish identity.) If an employee objects to the photo requirement for
religious reasons,the Employer
should contact E-Verify at 888-464-4218.
• if an employee presents a OHS Form 1-551 (Permanent Resident Card)or Form 1-766
(Employment Authorization Document)to complete the Form 1-9,the Employer agrees to
make a photocopy of the document and to retain the photocopy with the employee's
Form 1-9. The photocopy must be of sufficient quality to allow for verification of the photo
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and written information. The employer will use the photocopy to verify the photo and to
assist DHS with its review of photo non-matches that are contested by employees.Note
that employees retain the right to present any List A,or List B and List C,documentation
to complete the Form 1-9. DHS may in the future designate other documents that
activate the photo screening tool.
6. The Employer understands that participation in E-Verify does not exempt the Employer from
the responsibility to complete, retain, and make available for inspection Forms 1-9 that relate to
its employees, or from other requirements of applicable regulations or laws, including the
obligation to comply with the antidiscrimination requirements of section 274E of the INA with
respect to Form 1-9 procedures, except for the following modified requirements applicable by
reason of the Employer's participation in E-Verify: (1) identity documents must have photos, as
described in paragraph.5 above; (2) a rebuttable presumption.is established that the Employer
has not violated section 274A(a)(1)(A) of the immigration and Nationality Act(INA) with respect
to the hiring of any individual If it obtains confirmation of theidentibtandemployment efigibitityi bf'
the individual in good faith compliance with the terms and conditions of E-Verify; (3) the
Employer must notify DHS if It continues to employ any employee after .receiving a final
nonconfirmation, and is subject to a civil money penalty between $550 and $1,100 for each
failure to notify DHS of continued employment following .a final nonconfimmation; (4) the
Employer is subject to a rebuttable presumption that it has knowingly employed an unauthorized
alien in violation of section 274A(a)(1)(A)if the Employer continues to employ an employee after
receiving a final nonconfirmation; and (5) no person or entity participating in E-Verify is civilly or .
criminally liable under any law for any action taken in good faith based on information provided
through the confirmation system. OHS reserves the right to conduct Form 1-9 and E-Verify
system compliance inspections during the course of E-Verify, as well as to conduct any other
enforcement activity authorized by law.
7. The Employer agrees to initiate E-Verify verification procedures for new employees within 3
Employer business days after each employee has been hired (but after the Form 1-9 has been
completed), and to complete as many (but only as many) steps of the E-Verify process as are
necessary according to the E-Verify User Manual, or in the case of Federal contractors with the
FAR E-Verify clause, the E-Verify User Manual for Federal Contractors. The Employer is
prohibited from initiating verification procedures before the employee has been hired and the
Form 1-9 completed. If the automated system to be queried is temporarily unavailable, the 3-day
time period is extended until it is again operational in order to accommodate the Employer's
attempting, in good faith, to make inquiries during the period of unavailability. Employers may
initiate verification by notating the Form 1-9 in circumstances where the employee has applied
for a Social Security Number (SSN) from the SSA and is waiting to receive the SSN, provided
that the Employer performs an E-Verify employment verification query using the employee's
SSN as soon as the SSN becomes available.
8. The Employer agrees not to use E-Verify procedures for pre-employment screening of job
applicants, in support of any unlawful employment practice, or for any other use not authorized
by this MOU. Employers must use E-Verify for all new employees, unless an Employer is a
Federal contractor that qualifies for the exceptions described in Article 1€.D.1.c. Except as
provided in Article 11.0, the Employer will not verify selectively and will not verify employees
hired before the effective date of this MOU. The Employer understands that if the Employer
uses the E-Verify system for any purpose other than as authorized by this MOU, the Employer
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Company ID Number. 640632
may be subject to appropriate legal action and termination of its access to SSA and DHS
information pursuant to this MOU.
9. The Employer agrees to follow appropriate procedures (see Article ill. below) regarding
tentative nonconfirmations, including notifying employees in private of the finding and providing
them written notice of the findings, providing written referral instructions to employees, allowing
employees to contest the finding, and not taking adverse action against employees if they
choose to contest the finding. Further, when employees contest a tentative nonconfirmation
based upon a photo non-match, the Employer is required to take affirmative steps (see Article
111.B. below)to contact DHS with information necessary to resolve the challenge.
10. The Employer agrees not to take any adverse action against an employee based upon the
employee's perceived employment eligibility status whit SSA or OHS is processing the
verification request unless the Employer obtains knowledge,(as defined in 8 C:FR: § 274a.1(1))
that the employee is not work authorized. The Employer understands:that an.initial inability of
the SSA or OHS automated verification system to verify work authorization, a tentative
nonconfirmation, a case in continuance (indicating the need for additional time for the
government to resolve a case), or the finding of a photo non-match, does not establish, and
should not be interpreted as evidence, that the employee is not work.authorized. In any of the
cases listed above, the employee must be provided a full and fair opportunity to contest the
finding, and If he or she does so, the employee may not be terminated or suffer any adverse
employment consequences based upon the employee's perceived employment-eligibility status
(including denying, reducing, or extending work hours, delaying or preventing training, requiring
an employee to work in poorer conditions, refusing to assign the employee to a Federal contract
or other assignment, or otherwise subjecting an employee to any assumption that he or she is
unauthorized to work) until and unless secondary verification by SSA or OHS has been
completed and a final nonconfirmation has been issued. If the employee does not choose to
contest a tentative nonconfirmation or a photo non-match or if a secondary verification is
completed and a final nonconfirmation is issued,then the Employer can find the employee is not
work authorized and terminate the employee's employment. Employers or employees with
questions about a final nonconfirmation may call E-Verify at 1-888-464-4218 or OSC at 1-800-
255-8155 or 1-800-237-2515(TDD).
11. The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section
274E of the INA, as applicable, by not discriminating unlawfully against any individual in hiring,
firing, or recruitment or referral practices because of his or her national origin or, in the case of a
protected individual as defined in section 274B(a)(3) of the INA, because of his or her
citizenship status. The Employer understands that such illegal practices can include selective
verification or use of E-Verify except as provided in part D below, or discharging or refusing to
hire employees because they appear or sound "foreign" or have received tentative
nonconfirmations. The Employer further understands that any violation of the unfair immigration-
related employment practices provisions in section 2748 of the INA could subject the Employer
to civil penalties, back pay awards, and other sanctions, and violations of Title Vll could subject
the Employer to back pay awards, compensatory and punitive damages. Violations of either
section 274B of the INA or Title VII may also lead to the termination of its participation in E-
Verify. If the Employer has any questions relating to the anti-discrimination provision, It should
contact OSC at 1-800-255-8155 or 1-800-237-2515 (TDD).
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12. The Employer agrees to record the case verification number on the employee's Form 1-9 or
to print the screen containing the case verification number and attach it to the employee's Form
1-9.
13. The Employer agrees that it will use the information it receives from SSA or DHS pursuant
to E-Verify and this MOU only to confirm the employment eligibility of employees as authorized
by this MOU. The Employer agrees that it will safeguard this information, and means of access
to it (such as PINS and passwords)to ensure that it is not used for any other purpose and as
necessary to protect its confidentiality, including ensuring that it is not disseminated to any
person other than employees of the Employer who are authorized to perform the Employer's
responsibilities under this MOU,except for such dissemination as may be authorized in advance
by SSA or OHS for legitimate purposes.
14, The Employer acknowledges that the information which it receives from SSA is governed by
the Privacy Act(5 U.S.C. § 552a(I)(1) and (3)) and the Social:Security Act (42 U.S.C. 1306(a)),
and that any person who obtains this information under false pretenses or uses it for any
purpose other than as provided for in this MOU may be subject to criminal penalties.
15. The Employer agrees to cooperate with OHS and SSA in their compliance monitoring and -
evaluation of E-Verify, including by permitting OHS and SSA, upon reasonable notice,to review
Forms 1-9 and other employment records and to interview it and its employees regarding the
Employer's use of E-Verify, and to respond in a timely and accurate manner to•OHS requests
for information relating to their participation in E-Verify.
D.RESPONSIBILITIES OF FEDERAL CONTRACTORS WITH THE FARE-VERIFY CLAUSE
1. The Employer understands that if it is a subject to the employment verification terms
in Subpart 22.18 of the FAR, it must verify the employment eligibility of any existing employee
assigned to the contract and all new hires, as discussed in the Supplemental Guide for Federal
Contractors. Once an employee has been verified through E-Verify by the Employer, the
Employer may not reverify the employee through E-Verify.
a. Federal contractors with the FAR E-Verify clause agree to become familiar with and
comply with the most recent versions of the E-Verify User Manual for Federal Contractors and
the E-Verify Supplemental Guide for Federal Contractors.
b. Federal contractors with the FAR E-Verify clause agree to complete a tutorial for
Federal contractors with the FAR E-Verify clause.
c. Federal contractors with the FAR E-Verify clause not enrolled at the time of contract
award: An Employer that is not enrolled in E-Verify at the time of a contract award must enroll
as a Federal contractor with the FAR E-Verify clause in E-Verify within 30 calendar days of
contract award and, within 90 days of enrollment, begin to use E-Verify to initiate verification of
employment eligibility of new hires of the Employer who are working in the United States,
whether or riot assigned to the contract. Once the Employer begins verifying new hires, such
verification of new hires must be initiated within 3 business days after the date of hire. Once
enrolled in E-Verify as a Federal contractor with the FAR E-Verify clause, the Employer must
initiate verification of employees assigned to the contract within 90 calendar days from the time
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of enrollment in the system and after the date and selecting which employees will be verified In
E-Verify or within 30 days of an employee's assignment to the contract,whichever date is later.
d. Employers that are already enrolled in E-Verify at the time of a contract award but are
not enrolled In the system as a Federal contractor with the FAR E-Verify clause: Employers
enrolled in E-Verify for 90 days or more at the time of a contract award must use E-Verify to
initiate verification of employment eligibility for new hires of the Employer who are working in the
United States, whether or not assigned to the contract, within 3 business days after the date of
hire. Employers enrolled in E-Verify as other than a Federal contractor with the FAR'E-Verify
clause, must update E-Verify to indicate that they are a Federal contractor with the FAR E-
Verify clause within 30 days after assignment to the contract. If the Employer is enrolled in E-
Verify for 90 calendar days or less at the time of contract award, the Employer must, within 90
days of enrollment, begin to use E-Verify to initiate verification of new hires of the contractor
who are working in the United States, whether or not assigned to the contract,.Such:verification:
of new hires must be initiated within 3 business days after-the--date.of'hire. An,Employer
enrolled as a Federal contractor with the FAR E-Verify clause in E-Verify must 'initiate
verification of each employee assigned to the contract within 90 calendar days, after date of
contract award or within 30 days after assignment to the contract, whichever is later.
e. institutions of higher education, State, local and tribal governments and sureties:
Federal contractors with the FAR E-Verify clause that are institutions of higher-education (as
defined at 20 U.S.C. 1001(a)), State or local governments, governments of Federally.recognized
Indian tribes, or sureties performing under a takeover agreement entered into_with-a Federal
agency pursuant to a performance bond may choose to only verify new and existing employees
assigned to the Federal contract. Such Federal contractors with.the'FAR-E-Verify clause mays
however, elect to verify all new hires, and/or all existing employees hired after November 6,
1986. The provisions of Article 11.D, paragraphs 1.13 and 1.b of this MOU providing timeframes
for initiating employment verification of employees assigned to a contract apply to such
institutions of higher education, State, local and tribal governments, and sureties.
f. Verification of all employees: Upon enrollment, Employers who are Federal contractors
with the FAR E-Verify clause may elect to verify employment eligibility of all existing employees
working in the United States who were hired after November 6, 1986, instead of verifying only
new employees and those existing employees assigned to a covered Federal contract. After
enrollment, Employers must elect to do so only in the manner designated by DHS and initiate E-
Verify verification of all existing employees within 180 days after the election.
g. Form 1-9 procedures for existing employees of Federal contractors with the FAR E-
Verify clause: Federal contractors with the FAR E-Verify clause may choose to complete new
Forms 1-9 for all existing employees other than those that are completely exempt from this
process. Federal contractors with the FAR E-Verify clause may also update previously
completed Forms 1-9 to initiate E-Verify verification of existing employees who are not
completely exempt as long as that Form 1-9 is complete (including the SSN), complies with
Article Il.C.5, the employee's work authorization has not expired, and the Employer has
reviewed the information reflected in the Form 1-9 either in person or in communications with the
employee to ensure that the employee's stated basis in section 1 of the Form 1-9 for work
authorization has not changed (including, but not limited to, a lawful permanent resident alien
having become a naturalized U.S. citizen). If the Employer is unable to determine that the Form
Page 7 of 13 i E-Verify MOU for Employer 1 Revision Date 09101/09 www.dhs.gov/E-Verity
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fit_ ,�,
.. :111.111111 A' 10,
Company ID Number:640532
1-9 complies with Article II.C.5, if the employee's basis for work authorization as attested in
section 1 has expired or changed, or if the Form i-9 contains no SSN or is otherwise incomplete,
the Employer shall complete a new 1-9 consistent with Article II.C.5, or update the previous 1-9
to provide the necessary information. If section 1 of the Form 1-9 is otherwise valid and up-to-
date and the form otherwise complies with Article II.C.5, but reflects documentation (such as a
U.S. passport or Form 1-551) that expired subsequent to completion of the Form 1-9, the
Employer shall not require the production of additional documentation, or use the photo
screening tool described in Article I1.C.5, subject to any additional or superseding instructions
that may be provided on this subject in the Supplemental Guide for Federal Contractors.
Nothing in this section shall be construed to require a second verification using E-Verify of any
assigned employee who has previously been verified as a newly hired employee under this
MOU, or to authorize verification of any existing employee by any Employer that is not a Federal
contractor with the FAR E-Verify clause.
2. The Employer understands that if it is a Federal contractor'with the.FAR.E-Verify clause, Its
compliance with this MOU is a performance requirement under the terms of the Federal
contract or subcontract, and the Employer consents to the release of information relating to
compliance with its verification responsibilities under this MOU to contracting officers or other • -
officials authorized to review the Employer's compliance with Federal contracting requirements.
ARTICLE Iit
REFERRAL OF INDIVIDUALS TO SSA•AND DHS -
A. REFERRAL TO SSA
1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must print
the notice as directed by the E-Verify system and provide it to the employee so that the
employee may determine whether he or she will contest the tentative nonconfirmation. The
Employer must review the tentative nonconfirmation with the employee in private.
2. The Employer will refer employees to SSA field offices only as directed by the automated
system based on a tentative nonconfirmation, and only after the Employer records the case
verification number, reviews the input to detect any transaction errors, and determines that the
employee contests the tentative nonconfirmation.The Employer will transmit the Social Security
Number to SSA for verification again if this review indicates a need to do so. The Employer will
determine whether the employee contests the tentative nonconfirmation as soon as possible
after the Employer receives it.
3. If the employee contests an SSA tentative nonconfirmation,the Employer will provide the
employee with a system-generated referral letter and instruct the employee to visit an SSA
office within 8 Federal Government work days. SSA will electronically transmit the result of the
referral to the Employer within 10 Federal Government work days of the referral unless it
determines that more than 10 days is necessary. The Employer agrees to check the E-Verify
system regularly for case updates.
4. The Employer agrees not to ask the employee to obtain a printout from the Social Security
Number database (the Numident) or other written verification of the Social Security Number
from the SSA.
Page 8 of 13 I E-Verify MOW for Emp'oyer I Revision Date 09101109 www.dhs.gov/E-Verify
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Vera40, a‘cck,,,"
Company ID Number:640532
B.REFERRAL TO DHS
1. If the Employer receives a tentative nonconfirmation Issued by DHS, the Employer must print
the tentative nonconfirmation notice as directed by the E-Verify system and provide it to the
employee so that the employee may determine whether he or she will contest the tentative
nonconfirmation. The Employer must review the tentative nonconfirmation with the employee in
private.
2. If the Employer finds a photo non-match for an employee who provides a document for which
the automated system has transmitted a photo, the employer must print the photo non-match
tentative nonconfirmation notice as directed by the automated system and provide it to the
employee so that the employee may determine whether he or.she will contest the finding. The
Employer must review the tentative nonconfirmation with the employee in private.
3. The Employer agrees to refer individuals to OHS only when the employee chooses t000ntest
a tentative nonconfirmation received from OHS automated verification process or when the
Employer issues a tentative nonconfirmation based upon a photo non-match. The Employer will
determine whether the employee contests the tentative nonconfirmation as soon as possible
after the Employer receives it.
4. If the employee contests a tentative nonconfirmation issued by OHS, the Employer will
provide the employee with a referral letter and instruct the employee to contact OHS through its.-
toll-free hotline(as found on the referral letter)within 8 Federal Government work days.
5. 1f the employee contests a tentative nonconfirmation based upon a photo non-match,the
Employer will provide the employee with a referral letter to DHS. OHS will electronically transmit
the result of the referral to the Employer within 10 Federal Government work days of the referral
unless it determines that more than 10 days is necessary. The Employer agrees to check the E-
Verify system regularly for case updates.
6.The Employer agrees that if an employee contests a tentative nonconfirmation based upon a
photo non-match,the Employer will send a copy of the employee's Form 1-551 or Form 1-766 to
DHS for review by:
•Scanning and uploading the document,or
• Sending a photocopy of the document by an express mail account(paid for at
employer expense).
7. If the Employer determines that there is a photo non-match when comparing the photocopied
List B document described in Article II.C.5 with the image generated in E-Verify, the Employer
must forward the employee's documentation to OHS using one of the means described in the
preceding paragraph, and allow OHS to resolve the case.
ARTICLE IV
SERVICE PROVISIONS
Page 9 of 131E-Verify MOU for Employer I Revision Date 09/01/09 www.dhs.govlE-Verify
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•
..=:Y -Veri
. ,. fly e
Company ID Number:640532
SSA and DHS will not charge the Employer for verification services performed under this MOU.
The Employer is responsible for providing equipment needed to make inquiries. To access E-
Verify, an Employer will need a personal computer with Internet access.
,ARTICLE V
PARTIES
A. This MOU is effective upon the signature of all parties, and shall continue in effect for as long
as the SSA and OHS conduct the E-Verify program unless modified in writing by the mutual
consent of all parties, or terminated by any party upon 30 days prior written notice to the others.
Any and all system enhancements to the E-Verify program by DHS or SSA, including but not
limited to the E-Verify checking against additional data sources and instituting new verification
procedures, will be covered under this MOU and will not cause the need for a supplemental
MOU that outlines these changes. OHS agrees to train employers on all changes made to E-
Verify through the use of mandatory refresher tutorials and updates:to the:E-Verify User
Manual, the E-Verify User Manual for Federal Contractors or the E-Verify Supplemental Guide
for Federal Contractors. Even without changes to E-Verify, OHS reserves the right to require
employers to take mandatory refresher tutorials. An Employer that is a Federal contractor with
the FAR E-Verify clause may terminate this MOU when the Federal contract that requires its
participation in E-Verify is terminated or completed. in such a circumstance, the Federal
contractor with the FAR E-Verify clause must provide written notice to OHS. If-an Employer that
is a Federal contractor with the FAR E-Verify clause fails to provide such notice, that Employer
will remain a participant in the E-Verify program, will remain bound by the terms of this MOU
that apply to participants that are not Federal contractors with the FAR E-Verify clause, and will
be required to use the E-Verify procedures to verify the employment eligibility of all newly hired
employees.
B. Notwithstanding Article V, part A of this MOU, OHS may terminate this MOU if deemed
necessary because of the requirements of law or policy, or upon a determination by SSA or
OHS that there has been a breach of system integrity or security by the Employer, or a failure
on the part of the Employer to comply with established procedures or legal requirements. The
Employer understands that if it is a Federal contractor with the FAR E-Verify clause,termination
of this MOU by any party for any reason may negatively affect its performance of its contractual
responsibilities.
C. Some or all SSA and OHS responsibilities under this MOU may be performed by
contractor(s), and SSA and DHS may adjust verification responsibilities between each other as
they may determine necessary. By separate agreement with DHS, SSA has agreed to perform
its responsibilities as described in this MOU.
D. Nothing in this MOU is intended, or should be construed, to create any right or benefit,
substantive or procedural, enforceable at law by any third party against the United States, its
agencies, officers, or employees, or against the Employer, its agents, officers,or employees.
E. Each party shall be solely responsible for defending any claim or action against it arising out
of or related to E-Verify or this MOU, whether civil or criminal, and for any liability wherefrom,
including (but not limited to) any dispute between the Employer and any other person or entity
Page 10 of 131 E-Verify MOU for Employer I Revision Date 09/01109 www.dhs.govlE-Verify
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. Eve
nry:
Company ID Number:640532
regarding the applicability of Section 403(d) of IIRIRA to any action taken or allegedly taken by
the Employer.
F. The Employer understands that the fact of its participation in E-Verify is not confidential
information and may be disclosed as authorized or required by law and DHS or SSA policy,
including but not limited to, Congressional oversight, E-Verify publicity and media inquiries,
determinations of compliance with Federal contractual requirements, and responses to inquiries
under the Freedom of Information Act(FOR).
G. The foregoing constitutes the full agreement on this subject between DHS and the Employer.
H. The individuals whose signatures appear below represent that they are authorized to enter
into this MOL)on behalf of the Employer and DHS respectively..
Page 11 of 131.E-Verify MOU for Employer I Revision Date 08/01/09 www.clbs.gov/E-Verify
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March 16, 2010
FLORIDADEPARTMENT OF STATE
Dnnsicn etormmica s
LAWSON PRODUCTS, INC.
1666 E. TOUBY AVE.
DES PLAINES, IL 60018
Qualification documents for LAWSON PRODUCTS, INC. were filed on
March 15, 2010 and whenever assigned
sig spdoc m tin number aP10000001302. Please refer to
this number
Your corporation is now qualified and authorized to transact business in
Florida as of the file date.
This document was electronically received and filed under FAX audit number
E10000058807.
A corporation annual report/uniform business report will be due this
office between January 1 and May 1 of the year following the calendar year
of the file date. A Federal Employer Identification (PEI) number will be
required before this report can be filed. If you do not already have an
PEI number, please apply NOW with the Internal Revenue by calling
1-800-829-4933 and requesting form SS-4.
Please be aware if the corporate address changes, it is the responsibility
of the corporation to notify this office.
Should you have any questions regarding this matter, please contact this
office at (850) 245-6995.
Wanda_.Cunningham....._._.. ..... .
Regulatory Specialist II
New Piling Section
Division of Corporations Letter Number; 9110600006439
P.0 BOX 6321-Tallahassee,Plonda 32314
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APPLICATION BY YORINGS1 CO OMflOP1aoRAtnIIoRnwzxortTo TRANSACT
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12. Now.M bodamo addresses of officers sailor directors:
A. DIRECTORS
anima; Please see Exhibit A attached hereto
Address: ■■■■•■•■■•■•••■■•■••■■■•••■
Via Chairmen
Address:
Director
Address:
Diatom
Address: , A111.1.1=10..,0,•■••■••■•■•■■■••■•
B. OFFICERS
Pfd ow PiCOSO no Exhibit A attached hereto Ao■olook.......••••■••
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NOTE: If sooners,plumy sloth addends=to the application.listing edditioard officers sodior directors.
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APPLICATION BY FOREIGN CORIDA RPORA1TON FOR
Item Nos. 12A and 12.B. The following are the names and addresses of the office:3 and
directors ofLeerson Products,Inc.:
•
CORPORAT1r OFFEZRE
•
I
President end Chlefibmentive officer Thomas t.NeII 1666 8.Took/Mane,Dar Plaines.IL 60018
•
lbw Vice President and RenyDootelli 1666 S.Molly Avenue,Des Plains,II.60018
Chet' Officer
and Owed Catgut
Secretary Neil hakins 1666 S.Tauity Avenue,Des Plaines,IL 60018
Senior Vice President,Technology
loo Robed Border 1666$.7bWty Avenue,Des Macs,IL 60018
Senior VW President,Business Development
Strategic Stewart Howley 1666 Sthuhy Avenue,Des PlaDee Plaines,IL 60018
•
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Senior Woe Ptaddmt and Ronald Knutson 1666$.Talky Avetasn,,Da Plates.IL 60018
Chetirmmelel Meer
es1or Vi
S B and Roma 1666 S.Milky Avenue,Des Flakes,IL 6001*
Hamm Resources Mazy Elm P 16668.ToWtyAveeura,Dan plainee,>L601118
Vi0e meat'Ccetroller Victor G.Oahu 1666 8 Tony Avenue,Des Plsines,11.60018
Vies Pretident,The aer William Holmes 1666$.TbuhyAvenoto,,Des Planes,IL 60018
Vida Peestdoi Roam Mlohed'Ihveli 166613.Inuby Avenue,Des Plains,8L 60018
Vice President and Counsel,Chief Prank Ziegler 1666$.TcullyMenne,Des Plebss,ILb00j8
w$ d oe=owanAssisi!
osemy
Vico Presides;Outbound Sam
Customer Salvia:and Llcd Nathanson 1666$.Toulty Avenue,Der Plaines,IL 60018
Vice Preddeas.Sates George H.Buo1Cinglaaa 1666$.Touby Avenue,Dot Plafaee,11.60011 •
Vice bidden,Sake Alien Jacobsen 1666 S.Toby Avenae,Dos Mines./1.6001$ •
Vine Padden,ktultestog Lisa'Caplan 1666 E.Toby Avenue,Des Maims,1L60018
Vice Pseddest,National Accounts Shoo Libby 1666 E.rooky Moose,Des Plains.II,60018
Vice .lam and Shane McCansthy 1666E.ibohy Avenue,Des Places.ILd001*
•
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V i c e Plaided,S +Nenageramtt Peldek Poole 1666 8 TotdtyAvenue,Des Pialaai,LL 60018
Sales Planning and Robert 1lutbet 16668.Toby Avenue,Des Plaines„IL 60018
Vice Proddast.Sake Rick%Race 1666 E.Took Avenue,Des Plains,IL.60018
•
Vise Prodders,Product Marketing Christian Wiest 1666 8 Talky Avenue,Vas Mom 11.600111 •
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Ronald N.Pet,81.D.(Chair) 1666 RToahyAmok Dos plaboe.11.60018
Thames L Ned 1666 E.Told y Avenue,Des Fishes,IL 60018
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To all to whom these Presents Shall Come, Greeting:
I,Jesse White, Secretary of State of the State of Illinois, do
hereby certify that
LAWSON PRODUCTS,INC.,A DOMESTIC CORPORATION,INCORPORATED UNDER THE
LAWS OF THIS STATE ON OCTOBER 21,2009,APPEARS TO HAVE COMPLIED WITH ALL
THE PROVISIONS OF THE BUSINESS CORPORATION ACT OF THIS STATE RELATING TO
THE PAYMENT OF FRANCHISE TAXES,AND AS OF THIS DATE,IS IN GOOD STANDING
AS A DOMESTIC CORPORATION IN THE STATE OF ILLINOIS.
Iv- In Testimony Whereof,
I hereto set
_j_f„,, ,, my hand and cause to be affixed the Great Seal of
-k► tU r-'', g Illinois,this 15TH
;';�:,� �_1;; the State of �
�� .X f day o MARCH A.D. 2010•t/• r :; t: day of s
/ aeit 1SOT,/D2062 k....104.■414".. kk)roto&
M ono *6t SECNETARY Of STATE
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Packet Page-2332-
5/28/2013 16.E.2.
2013 FOREIGN PROFIT CORPORATION ANNUAL REPORT
DOCUMENT#F10000001302 FILED Apr 08,Entity Name: LAWSON PRODUCTS, INC. Secretary of State
Current Principal Place of Business:
8770 W.BRYN MAWR AVENUE
SUITE 900
CHICAGO, IL 60631
Current Mailing Address:
8770 W. BRYN MAWR AVENUE
SUITE 900
CHICAGO, IL 60631 US
FEI Number:80-0496603 Certificate of Status Desired: No
Name and Address of Current Registered Agent:
C T CORPORATION SYSTEM
1200 SOUTH PINE ISLAND ROAD
PLANTATION,FL 33324 US
The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida,
SIGNATURE:
Electronic Signature of Registered Agent Date
Officer/Director Detail Detail:
Title PRESIDENT AND CEO Title
SR.VICE PRESIDENT,FINANCE;
Name DECATA,MICHAEL G TREASURER AND CONTROLLER
Address 8770 W.BRYN MAWR AVENUE Name TUVELL,MICHAEL
SUITE 900 Address 8770 W.BRYN MAWR AVENUE
City-State-Zip: CHICAGO IL 60631 SUITE 900
City-State-Zip: CHICAGO IL 60631
Title EVP,SECRETARY
Name JENKINS,NEIL E Title CIO
Address 8770 W.BRYN MAWR AVENUE Name BORDER ROBERT
SUITE 900 Address 8770 W.BRYN MAWR AVENUE
City-State-Zip: CHICAGO IL 60631 SUITE 900
City-State-Zip: CHICAGO IL 60631
Title VCFO
Name KNUTSON,RONALD
Address 8770 W.BRYN MAWR AVENUE
SUITE 900
City-State-Zip: CHICAGO IL 60631
I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shad have the same legal effect as if made under
oath;that l am an officer or director of the corporation or the reeewer or trustee empowered to execute this report as required by Chapter 607,Florida Statutes;and that my name appears
above,ore,,an attachment with at other&a empowered.
SIGNATURE:NEIL E. JENKINS EVP, SECRETARY 04/08/2013
Electronic Signature of Signing Officer/Director Detail
Date
Packet Page-2333-
5/28/2013 16.E.2.
2013 FOREIGN PROFIT CORPORATION ANNUAL REPORT FILED
DOCUMENT#F10000001302 Apr 08, 2013
Secretary of State
Entity Name: LAWSON PRODUCTS, INC.
Current Principal Place of Business:
8770 W.BRYN MAWR AVENUE
SUITE 900
CHICAGO, IL 60631
Current Mailing Address:
8770 W. BRYN MAWR AVENUE
SUITE 900
CHICAGO, IL 60631 US
FEI Number: 80-0496603 Certificate of Status Desired: No
Name and Address of Current Registered Agent:
C T CORPORATION SYSTEM
1200 SOUTH PINE ISLAND ROAD
PLANTATION,FL 33324 US
The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida.
SIGNATURE:
Electronic Signature of Registered Agent Date
Officer/Director Detail Detail:
Title PRESIDENT AND CEO Title SR.VICE PRESIDENT,FINANCE;
TREASURER AND CONTROLLER
Name DECATA,MICHAEL G Name TUVELL,MICHAEL
Address 8770 W.BRYN MAWR AVENUE Address 8770 W.BRYN MAWR AVENUE
SUITE 900 SUITE 900
City-State-Zip: CHICAGO IL 60631 City-State-Zip: CHICAGO IL 60631
Title EVP,SECRETARY
Title CIO
Name JENKINS,NEIL E Name BORDER,ROBERT
Address 8770 W.BRYN MAWR AVENUE Address 8770 W.BRYN MAWR AVENUE
SUITE 900 SUITE 900
City-State-Zip: CHICAGO IL 60631 City-State-Zip: CHICAGO IL 60631
Title VCFO
Name KNUTSON,RONALD
Address 8770 W.BRYN MAWR AVENUE
SUITE 900
City-State-Zip: CHICAGO IL 60631
I hereby certify that the information indicated on this report or supplemental report is true and accurate end that my electronic signature shall have the same legal effect as if made under
oath;that 1 em an officer or director of the corporation or the receiver or trustee empowered to execute this report es required by Chapter 607,Florida Stables and that my name appears
above,or on an attachment with all other like empowered.
SIGNATURE:NEIL E.JENKINS EVP, SECRETARY 04/08/2013
Electronic Signature of Signing Officer/Director Detail Date
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5/28/2013 16.E.2.
C.0c. Ter County
Adm r,istralive Services Division
Purchasing
INVITATION TO BID
Date: April 1, 2013
From: Adam Northrup, Procurement Strategist
(239) 252-6098 (Telephone)
(239) 252-6302 (FAX)
adamnorthrup @colliergov.net (Email)
To: Prospective Vendors
Subject: Solicitation: 13-6018—Fasteners and Wheel Weights
As requested by the Fleet Management Department, the Collier County Board of
County Commissioners Purchasing Department has issued this ITB for the purpose of
obtaining fair and competitive responses.
Please refer to the Public Notice included in this document for the opening date and
time and any applicable pre-ITB conference.
All questions regarding this ITB must be submitted online on the Collier County
Purchasing Department Online Bidding System website: www.colliergov.net/bid. All
responses to questions will be posted on the website with electronic notification to all
prospective vendors.
We look forward to your participation in Collier County's competitive procurement
process.
cc: Dan Croft, Lynn Evans
Purchasrg Deoanr eM•3327Tamiami Trail Easl•Naples,Florida 34112.4901•www.col6ergov.nettpurchasing
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Invitation to Bid
Index
Public Notice 3
Exhibit I: Scope of Work, Specifications and Response Format 4
Exhibit II: General Bid Instructions 8
Exhibit Ill: Standard Purchase Order Terms and Conditions 14
Exhibit IV: Additional ITB Terms and Conditions 17
Attachment 1: Vendor Submittal -Vendor's Non-Response Statement 24
Attachment 2: Vendor's Check List 25
Attachment 3: Vendor Submittal - Bid Response Form 26
Attachment 4: Vendor Submittal— Local Vendor Preference Affidavit 28
Attachment 5: Vendor Submittal— Immigration Affidavit 29
Attachment 6: Vendor Substitute W—9 30
Attachment 7: Vendor Submittal - Insurance and Bonding Requirements 31
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Public Notice
Sealed bid responses for Solicitation 13-6018—Fasteners and Wheel Weights, will be
received electronically only at the Collier County Government, Purchasing Department, online
bidding site at www.colliergov.net/bid until 3:00PM, Collier County local time on April 22, 2013.
Solicitation responses received after the stated time and date will not be accepted.
Solicitation 13-6018— Fasteners and Wheel Weights
All questions regarding this ITB must be submitted online on the Collier County Purchasing
Department Online Bidding System website: www.colliergov.net/bid. All responses to questions
will be posted on the website with electronic notification to all prospective vendors.
All solicitation responses must be made on the official ITB response form included and only
available for download from the Collier County Purchasing Department Online Bidding System
website noted herein. ITB Documents obtained from sources other than Collier County
Purchasing may not be accurate or current.
Collier County encourages vendors to utilize recycled paper on all manual bid response
submittals.
Collier County does not discriminate based on age, race, color, sex, religion, national origin,
disability or marital status.
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
BY: /s/Joanne Markiewicz
Interim Purchasing/General Services Director
Publicly posted on the Collier County Purchasing Department website:
www.colliergov.net/purchasing and in the lobby of the Purchasing Building on 04/01/2013.
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Exhibit I: Scope of Work, Specifications and Response Format
As requested by the Collier County Fleet Management Department (hereinafter, the "Division or
Department"), the Collier County Board of County Commissioners Purchasing Department
(hereinafter, "County") has issued this Invitation to Bid (hereinafter, "ITB") with the intent of obtaining
bids from interested and qualified firms in accordance with the terms, conditions and specifications
stated or attached. The Vendor, at a minimum, must achieve the requirements of the Scope of Work
and specifications stated.
The results of this solicitation may be used by other County departments once awarded according to
the Board of County Commissioners Purchasing Policy.
Brief Description of Purchase
These specifications are intended to provide information by which prospective bidders may
understand requirements relative to furnishing fasteners and wheel weights for maintenance and
repair of automobiles, trucks, and other equipment falling under the purview of the Collier County
Board of County Commissioners, hereafter referred to as "County."
Fasteners shall include; bolts, screws, nuts, pins, retainers, washers, clamps, grommets, rings, wire,
springs, connectors, rivets, caps, plugs, tubing, fuses, body hardware and hydraulic hoses, valves,
connectors, and hydraulic crimping equipment and associated repair parts. Historically, County
departments have spent approximately $57,000.
Detailed Scope of Work
All bid quotations must be made on Attachment 8: Bid Schedule, and then reported on the attached
Vendor Bid Response Form. The form must be completed in total. Your bid may not be accepted
unless all requested information is furnished. If a particular item cannot be provided, then write "not
available" on that line item. Bids shall reflect net delivered prices based on firm fixed percentage
discounts or markups from the current price lists for fasteners and for wheel weights.
Bid prices shall include all transportation, delivery, or administrative charges. No additional
transportation or delivery charges will be paid under this contract including special order items. No
additional surcharges of any kind will be accepted in conjunction with this contract. The product
manufacturers, price list type and source used for the quote, and price discount/markup percentages
shall remain constant throughout the life of the agreement.
After award, the County will accept price changes no more frequent than quarterly beginning one year
from the date of award. Thereafter, updates to pricing sheets shall be provided to the Collier County
Fleet Management Department on or before the first of each quarter with an effective date of the first
workday of each quarter.
It is requested that the vendor provide a real time, web-based online pricing system that reflects the
actual pricing the County will pay for each item ordered. Vendor will be responsible for updating the
web site to reflect approved pricing changes immediately upon approval. The County reserves the
right to request a demo of the online system prior to award of any contract. If such a system is not
available, please explain how invoices will be validated.
Supply & Delivery
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The successful bidder must perform periodic on-site inventory and stocking of Fleet Management
fastener and wheel weight supply bins with sufficient frequency to ensure a constant adequate supply ff�,
is available for fleet operating requirements. Orders will be placed only upon approval of the Parts
Manager, Maintenance Supervisor, or Shop Manager. Fastener and wheel weight orders must be
delivered prior to exhaustion of any on-hand supplies. All supply bins will be furnished by the vendor
at no cost to the County. Delivery locations are the following Fleet Management Parts Room
locations:
2901 County Barn Road, Naples, Florida 34112
4800 Davis Boulevard, Naples, Florida 34104
402 Sgt. Joe Jones Road, Immokalee, Florida 34142
8300 Radio Road, Naples, Florida 34104
Deviation from the Specifications
Bidder shall clearly indicate on the Proposal page or on a separate sheet of paper, all areas in which
the unit they propose does not fully comply with the requirements of this specification. The decision
whether an item fully complies with the stated requirements or whether to accept a minor deviation
rests solely with Collier County.
Product Quality
All nuts, bolts, cap screws, and washers supplied under this contract shall be certifiable Grade 8
except when stainless steel fasteners are requested. Stainless steel fasteners shall be SAE 316
marine grade. All hydraulic fittings and hoses supplied under this contract shall be Weatherhead
Brand. All other products supplied shall be top quality by automotive industry standards. Vendor's
bid must reflect the standards listed in this section.
Award Criteria
ITB award criteria is as follows:
• All questions on the Bid document shall be answered as to price(s), time requirements, and
required document submissions.
• Award shall be based upon the responses to all questions on the Bid Response Page(s).
• Further consideration may include but not be limited to, references, completeness of bid
response and past performances on other County bids/projects.
• Prices will be read in public exactly as input on the electronic bid response form or written on
the manually submitted Bid Response Page(s) at the time of the bid opening; however, should
an error in calculations occur whenever unit pricing and price extensions are requested, the
unit price shall prevail. Mathematical miscalculations may be corrected by the County to
reflect the proper response.
• The County's Purchasing Department reserves the right to clarify a vendor's proposal prior to
the award of the solicitation.
• It is the intent of Collier County to award to the lowest, qualified and responsive vendor(s) in
accordance with the following methodology:
Complete Attachment 8: Bid Schedule, as follows:
I. Provide an overall percentage discount off your company's entire catalog in
line one (1).
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II. Provide List Price and Package Quantity for lines two through one hundred (2-
100).
III. Using the percentage discount provided in line one (1), fill in column G.
"Discounted Price" for lines two through one hundred (2-100).
IV. Your Discounted Price will then be automatically multiplied by our approximate
annual purchase and reported in column I. "Bid Price".
V. Bid Price for lines 2-100 will be totaled automatically in line 101 TOTAL.
VI. Report Lines 1 and 101 on Attachment 3. Vendor Response form.
***PLEASE SEE ATTACHED FILE "SAMPLE— 13-6018 —Attachment 8" FOR COMPLETE EXAMPLE***
• Collier County reserves the right to select one, or more than one suppliers, however, it is the
intent to award a primary and secondary vendor. The secondary vendor will be utilized when
primary vendor refuses or is unable to provide goods and services in a timely manner.
• Due to the nature of products such as these and the varying package sizes each manufacturer
can produce, Collier County reserves the right evaluate bids based on single item pricing.
The single item price will be determined by the following formula;
Discounted Price/ Package Size = Single Item Price
• The contract will be in the form of a standard County Purchase Order.
Quoted Products
Attachment 8 contains a cross section of items that the Department of Fleet Management will use.
Quantities referenced, by no means guarantees purchases. Any items not listed on Attachment 8
should be provided at the following formula:
list price * 1. Overall Percentage Discount
For any questions or clarifications about product descriptions on Attachment 8, please contact
Adam Northrup at, adamnorthruID colliergov.net.
Term of Contract
The contract term, if an award(s) is/are made is intended to be for three (3)years with two (2) one
year renewal options.
Prices shall remain firm for the initial term of this contract. Price adjustments are dependent upon
the consumer price index (CPI) over the past twelve (12) months, budget availability and program
manager approval.
Surcharges will not be accepted in conjunction with this contract, and such charges should be
incorporated into the pricing structure.
Projected Timetable
Event Date
Issue Solicitation Notice 04/01/2013
Last Date for Receipt of Written Questions 04/18/2013, 3:00PM
Solicitation Deadline Date and Time 04/22/2013, 3:00PM
Anticipated Evaluation of Submittals Week of 04/22/2013
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IAnticipated Board of County Commissioner's Contract
Approval Date I
Vendor Required Documents
• Attachment 2: Vendor's Check List
• Attachment 3: Vendor Bid Response Form
• Attachment 4: Local Vendor Preference
• Attachment 5: Immigration Law Affidavit
• Attachment 6: Vendor Substitute W-9
• Attachment 7: Insurance and Bonding Requirement
• Attachment 8: Bid Schedule
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Exhibit II: General Bid Instructions
1. Purpose/Objective
As requested by the Collier County departments or divisions identified in Exhibit 1, the Collier
County Board of County Commissioners Purchasing Department (hereinafter, the County) has
issued this Invitation to Bid (hereinafter, the "ITB", or "Bid") with the sole purpose and intent of
obtaining bid responses from interested and qualified firms in accordance with the terms,
conditions, and specifications stated and/or attached herein/hereto. The successful vendor will
hereinafter be referred to as the"Vendor"
All bids must be submitted on the Bid form furnished by the County noted in Attachments
2, 3, 4, 5, 6, and 7 of this ITB. No bid will be considered unless the Bid form is properly
signed.Vendor is responsible to read and follow the instructions very carefully, as any
misinterpretation or failure to comply with these instructions could lead to the bid submitted as
being rejected as non-responsive.
2. Pricing
Vendors must provide unit prices using the unit of measured specified by the County. All prices
will remain firm for a period of one hundred and eighty (180) calendar days from date of bid
opening. After award by the Board of County Commissioners, prices may only be adjusted as
outlined in Exhibit I: Term of Contract.
3. Alternate Bid Pricing
In the event that alternate pricing is requested, it is an expressed requirement of the bid to provide
pricing for all alternates as listed. The omission of a response or a no-bid or lack of a submitted
price will be the basis for the rejection of the submitted bid response. All bids responses received
without pricing for all alternates as listed will be considered technically non-responsive and will not
be considered for award.
4. Equal Product
Manufacturer's name, brand name and/or model number are used in these specifications for the
purpose of establishing minimum requirements of level of quality, standards of performance and/or
design required, and is in no way intended to prohibit the bidding of other manufacturer's items of
equal or similar material. An equal or similar product may be bid, provided that the product is
found to be equal or similar in quality, standard of performance, design, etc. to the item specified.
Where an equal or similar is bid, the Bid must be accompanied with two (2) complete sets of
factory information sheets (specifications, brochures, etc.) and test results, if applicable, of unit bid
as equal or similar.
Equal product samples, if required for evaluation, and at no cost to the County, must be submitted
with Bid. Unless otherwise directed in the solicitation, the bid will not be considered unless
samples are delivered to specified address by bid due date. The County shall be sole judge of
equality or similarity, and its decision shall be final in the best interest.
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5. Discounts
Any discounts or terms must be shown on the Bid form. Such discounts, if any, may be
considered in the award of tie bids. In no instance should payment terms less than fifteen (15)
calendar days be offered.
6. Exceptions
Vendors taking exception to any part or section of these specifications shall indicate such
exceptions on a separate sheet entitled "EXCEPTIONS TO SPECIFICATIONS." Failure to
indicate any exceptions to the specifications shall be interpreted as the Vendors intent to fully
comply with the specifications as written. The County, at its sole discretion, shall determine if the
exceptions are material in nature, and if the Vendor's exceptions may be declared grounds for
rejection of bid proposal.
7. Addenda
The County reserves the right to formally amend and/or clarify the requirements of the bid
specifications where it deems necessary. Any such addendum/clarification shall be in writing and
shall be distributed electronically to all parties who received the original bid specifications prior to
the deadline for submission of Bids. All changes to this ITB will be conveyed electronically through
a notice of addendum or questions and answers to all vendors registered under the applicable
commodity code(s) at the time when the original ITB was released, as well as those vendors who
downloaded the ITB document. Additionally, all addendums are posted on the Collier County
Purchasing Department Online Bidding System website: www.colliergov.net/bid. Before submitting
a bid response, please make sure that you have read all, understood clearly and complied
completely with any changes stated in the addenda as failure to do so may result in the rejection
of your submittal.
8. Bid Submission
All electronic bids shall be submitted online via the Collier County Purchasing Department Online
Bidding System: www.colliergov.net/bid.
Vendors who wish to receive copies of bids after the bid opening may view and download same
from the Collier County Purchasing Department Internet bid site.
9. Questions
If the vendor should be of the opinion that the meaning of any part of the Bid Document is
doubtful, obscure or contains errors or omissions it should report such opinion to the Procurement
Strategist before the bid opening date. Direct questions related to this ITB only to the Collier
County Purchasing Department Internet website: www.colliergov.net/bid. Questions will not be
answered after the date noted on the ITB.
Vendors must clearly understand that the only official answer or position of the County will be the
one stated on the Collier County Purchasing Department Online Bidding System website. For
general questions, please call the referenced Procurement Strategist identified in the Public
Notice.
10. Protests
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Any actual or prospective respondent to an Invitation to Bid, who has a serious and legitimate
issue with the ITB shall file a written protest with the Purchasing Director prior to the opening of
the bid or the due date for acceptance of bid. All such protests must be filed with the Purchasing
Director no later than 11:00 a.m. Collier County time on the advertised date for the opening of the
bid or the acceptance date for the Request for Proposals.
11. Rejection and Waiver
The County reserves the right to reject any and all bids, to waive defects in the form of bid, also to
select the bid that best meets the requirements of the County.
Vendors whose bids, past performance or current status do not reflect the capability, integrity or
reliability to fully and in good faith perform the requirements denoted may be rejected as non-
responsive. Bids that do not meet all necessary requirements of this solicitation or fail to provide
all required information, documents or materials may be rejected as non-responsive.
12. Local Vendor Preference (LVP)
The County is using the Competitive Sealed Quotation methodology of source selection for this
procurement, as authorized by Ordinance Number 87-25, and Collier County Resolution Number
2008-181 establishing and adopting the Collier County Purchasing Policy.
The Collier County Board of County Commissioners has adopted a Local Preference "Right to
Match" policy to enhance the opportunities of local businesses to receive awards of Collier County
purchases.
A"local business" is defined as a business that has a valid Business Tax Receipt, formerly known
as an Occupational License issued by either Collier or Lee County for a minimum of one (1)year
prior to a Collier County quote or proposal submission that authorizes the business to provide the
commodities or services to be purchased, and a physical business address located within the
limits of Collier or Lee Counties from which the vendor operates or performs business. Post Office
Boxes are not verifiable and shall not be used for the purpose of establishing said physical
address. In addition to the foregoing, a vendor shall not be considered a "local business" unless it
contributes to the economic development and well-being of either Collier or Lee County in a
verifiable and measurable way. This may include, but not be limited to, the retention and
expansion of employment opportunities, the support and increase to either Collier or Lee County's
tax base, and residency of employees and principals of the business within Collier or Lee County.
Vendors shall affirm in writing their compliance with the foregoing at the time of submitting their
quote or proposal to be eligible for consideration as a "local business" under this section.
When a qualified and responsive non-local business submits the lowest price quote, and the quote
submitted by one or more qualified and responsive local businesses is within ten percent (10%) of
the price submitted by the non-local business, then the local business with the apparent lowest
quote offer (i.e. the lowest local vendor) shall have the opportunity to submit an offer to match the
price(s) offered by the overall lowest, qualified and responsive vendor. In such instances, staff
shall first verify if the lowest non-local vendor and the lowest local vendor are in fact qualified and
responsive vendors.
Next, the Purchasing Department shall determine if the lowest local vendor meets the
requirements of Section 287.087 F.S.
If the lowest local vendor meets the requirements of 287.087, F.S., the Purchasing Department
shall invite the lowest local vendor to submit a matching offer to the Purchasing Department which
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shall be submitted within five (5) business days thereafter. If the lowest local vendor submits an
offer that fully matches the lowest quote from the lowest non-local vendor tendered previously,
then award shall be made to the local vendor. If the lowest local vendor declines or is unable to
match the lowest non local quote price(s), then award will be made to the lowest overall qualified
and responsive vendor. If the lowest local vendor does not meet the requirement of Section
287.087 F.S. and the lowest non-local vendor does, award will be made to the vendor that meets
the requirements of the referenced state law.
Vendor must complete and submit with its quote response the Affidavit for Claiming Status as a
Local Business which is included as part of this solicitation.
Failure on the part of a Vendor to submit this Affidavit with their quote response will
preclude said Vendor from being considered for local preference under this solicitation.
A Vendor who misrepresents the Local Preference status of its firm in a quote submitted to the
County will lose the privilege to claim Local Preference status for a period of up to one (1) year.
The County may, as it deems necessary, conduct discussions with any of the competing vendors
determined to be in contention for being selected for award for the purpose of clarification to
assure full understanding of, and responsiveness to solicitation requirements.
13. Immigration Affidavit Certification
Statutes and executive orders require employers to abide by the immigration laws of the United
States and to employ only individuals who are eligible to work in the United States.
The Employment Eligibility Verification System (E-Verify) operated by the Department of
Homeland Security (DHS) in partnership with the Social Security Administration (SSA), provides
an Internet-based means of verifying employment eligibility of workers in the United States; it is
not a substitute for any other employment eligibility verification requirements. The program will be
used for Collier County formal Invitations to Bid (ITB) and Request for Proposals (RFP) including
professional services and construction services.
Exceptions to the program:
• Commodity based procurement where no services are provided.
• Where the requirement for the affidavit is waived by the Board of County
Commissioners
Vendors/Bidders are required to enroll in the E-Verify program, and provide acceptable evidence
of their enrollment, at the time of the submission of the vendor's/bidder's proposal. Acceptable
evidence consists of a copy of the properly completed E-Verify Company Profile page or a copy of
the fully executed E-Verify Memorandum of Understanding for the company. Vendors are also
required to provide the Collier County Purchasing Department an executed affidavit certifying they
shall comply with the E-Verify Program. The affidavit is attached to the solicitation documents. If
the Bidder/Vendor does not comply with providing both the acceptable E-Verify evidence
and the executed affidavit the bidder's/vendor's proposal may be deemed non-responsive.
Additionally, vendors shall require all subcontracted vendors to use the E-Verify system for all
purchases not covered under the "Exceptions to the program" clause above.
For additional information regarding the Employment Eligibility Verification System (E-Verify)
program visit the following website: http://www.dhs.gov/E-Verify. It shall be the vendor's
responsibility to familiarize themselves with all rules and regulations governing this program.
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Vendor acknowledges, and without exception or stipulation, any firm(s) receiving an award shall
be fully responsible for complying with the provisions of the Immigration Reform and Control Act of
1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be
amended and with the provisions contained within this affidavit. Failure by the awarded firm(s) to
comply with the laws referenced herein or the provisions of this affidavit shall constitute a breach
of the award agreement and the County shall have the discretion to unilaterally terminate said
agreement immediately.
14. Lobbying
All firms are hereby placed on NOTICE that the County Commission does not wish to be lobbied
either individually or collectively about a project for which a firm has submitted a bid. Firms and
their agents are not to contact members of the County Commission for such purposes as
meetings of introduction, luncheons, dinners, etc. During the bidding process, from bid opening to
final Board approval, no firm or its agent shall contact any other employee of Collier County with
the exception of the Purchasing Department.
15. Certificate of Authority to Conduct Business in the State of Florida (Florida Statute
607.1501)
In order to be considered for award, firms must be registered with the Florida Department of State
Divisions of Corporations in accordance with the requirements of Florida Statute 607.1501 and
provide a certificate of authority (www.sunbiz.orq/search.html) prior to execution of a contract. A
copy of the document may be submitted with the solicitation response and the document number
shall be identified. Firms who do not provide the certificate of authority at the time of response
shall be required to provide same within five (5) days upon notification of selection for award. If the
firm cannot provide the document within the referenced timeframe, the County reserves the right
to award to another firm.
16. General Information
When it is deemed by the County that a bid cannot be awarded as originally intended, the County
reserves the right to award this bid through an approach which is the best interest of the County.
Alternate bids will not be considered unless authorized by the ITB. In case of identical bids tying
as low bid, the County shall ask vendors to submit certification that they have a drug-free
workplace in accordance with Section 287.087 Florida Statutes. Should all vendors provide said
certification; the County will give local vendor preference.
17. Bid Award Process
Award of contract will be made by the Board of County Commissioners in public session. Awards
pertaining to the Collier County Airport Authority will generally be made by that agency's approval
Board.
Award shall be made in a manner consistent with the County's Purchasing Policy. Award
recommendations will be posted outside the offices of the Purchasing Department as well as on
the Collier County Purchasing Department website on Wednesdays and Thursdays prior to the
County Commission meetings.
Any actual or prospective respondent who desires to formally protest the recommended contract
award must file a notice of intent to protest with the Purchasing Director within two (2) calendar
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days (excluding weekends and County holidays) of the date that the recommended award is
posted. Upon filing of said notice, the protesting party will have five (5) days to file a formal
protest and will be given instructions as to the form and content requirements of the formal protest.
A copy of the "Protest Policy" is available at the office of the Purchasing Director.
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Exhibit III: Standard Purchase Order Terms and Conditions
1. Offer delivery; provided that risk of loss prior to
This offer is subject to cancellation by the actual receipt of the goods by the COUNTY
COUNTY without notice if not accepted by nonetheless remain with VENDOR.
VENDOR within fourteen (14)days of issuance. b) No charges will be paid by the COUNTY for
packing, crating or cartage unless otherwise
2. Acceptance and Confirmation specifically stated in this Purchase Order.
This Purchase Order (including all documents Unless otherwise provided in Purchase
attached to or referenced therein) constitutes Order, no invoices shall be issued nor
the entire agreement between the parties, unless payments made prior to delivery. Unless
otherwise specifically noted by the COUNTY on freight and other charges are itemized, any
the face of this Purchase Order. Each delivery of discount will be taken on the full amount of
goods and/or services received by the COUNTY invoice.
from VENDOR shall be deemed to be upon the c) All shipments of goods scheduled on the
terms and conditions contained in this Purchase same day via the same route must be
Order. consolidated. Each shipping container must
be consecutively numbered and marked to
No additional terms may be added and Purchase show this Purchase Order number. The
Order may not be changed except by written container and Purchase Order numbers must
instrument executed by the COUNTY. VENDOR be indicated on bill of lading. Packing slips
is deemed to be on notice that the COUNTY must show Purchase Order number and
objects to any additional or different terms and must be included on each package of less
conditions contained in any acknowledgment, than container load (LCL) shipments and/or
invoice or other communication from VENDOR, with each car load of equipment. The
notwithstanding the COUNTY'S acceptance or COUNTY reserves the right to refuse or
payment for any delivery of goods and/or return any shipment or equipment at
services, or any similar act by VENDOR. VENDOR'S expense that is not marked with
Purchase Order numbers. VENDOR agrees
3. Inspection to declare to the carrier the value of any
All goods and/or services delivered hereunder shipment made under this Purchase Order
shall be received subject to the COUNTY'S and the full invoice value of such shipment.
inspection and approval and payment therefore d) All invoices must contain the Purchase Order
shall not constitute acceptance. All payments are number and any other specific information as
subject to adjustment for shortage or rejection. identified on the Purchase Order. Discounts
All defective or nonconforming goods will be of prompt payment will be computed from the
returned pursuant to VENDOR'S instruction at date of receipt of goods or from date of
VENDOR'S expense. receipt of invoices, whichever is later.
Payment will be made upon receipt of a
To the extent that a purchase order requires a proper invoice and in compliance with
series of performances by VENDOR, the Chapter 218, Fla. Stats., otherwise known as
COUNTY prospectively reserves the right to the "Local Government Prompt Payment
cancel the entire remainder of the Purchase Act," and, pursuant to the Board of County
Order if goods and/or services provided early in Commissioners Purchasing Policy.
the term of the Purchase Order are
non-conforming or otherwise rejected by the 5. Time Is Of the Essence
COUNTY. Time for delivery of goods or performance of
services under this Purchase Order is of the
4. Shipping and Invoices essence. Failure of VENDOR to meet delivery
a) All goods are FOB destination and must be schedules or deliver within a reasonable time, as
suitably packed and prepared to secure the interpreted by the COUNTY in its sole judgment,
lowest transportation rates and to comply shall entitle the COUNTY to seek all remedies
with all carrier regulations. Risk of loss of available to it at law or in equity. VENDOR
any goods sold hereunder shall transfer to agrees to reimburse the COUNTY for any
the COUNTY at the time and place of expenses incurred in enforcing its rights.
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VENDOR further agrees that undiscovered VENDOR shall indemnify and hold harmless the
delivery of nonconforming goods and/or services COUNTY from any and all claims, including
is not a waiver of the COUNTY'S right to insist claims of negligence, costs and expenses,
upon further compliance with all specifications. including but not limited to attorneys'fees, arising
from, caused by or related to the injury or death
6. Changes of any person (including
The COUNTY may at any time and by written y p (includin but not limited to
Y employees and agents of VENDOR in the
notice make changes to drawings and performance of their duties or otherwise), or
specifications, shipping instructions, quantities damage to property (including property of the
and delivery schedules within the general scope COUNTY or other persons), which arise out of or
of this Purchase Order. Should any such change are incident to the goods and/or services to be
increase or decrease the cost of, or the time provided hereunder.
required for performance of the Purchase Order,
an equitable adjustment in the price and/or 11. Warranty of Non-Infringement
delivery schedule will be negotiated by the VENDOR represents and warrants that all goods
COUNTY and VENDOR. Notwithstanding the sold or services performed under this Purchase
foregoing, VENDOR has an affirmative obligation Order are: a) in compliance with applicable laws;
to give notice if the changes will decrease costs. b) do not infringe any patent, trademark,
Any claims for adjustment by VENDOR must be copyright or trade secret; and c) do not constitute
made within thirty (30) days from the date the unfair competition.
change is ordered or within such additional
period of time as may be agreed upon by the VENDOR shall indemnify and hold harmless the
parties. COUNTY from and against any and all claims,
including claims of negligence, costs and
7. Warranties expense, including but not limited to attorneys'
VENDOR expressly warrants that the goods fees, which arise from any claim, suit or
and/or services covered by this Purchase Order proceeding alleging that the COUNTY'S use of
will conform to the specifications, drawings, the goods and/or services provided under this
samples or other descriptions furnished or Purchase Order are inconsistent with VENDOR'S
specified by the COUNTY, and will be of representations and warranties in section 11 (a).
satisfactory material and quality production, free
from defects and sufficient for the purpose If any claim which arises from VENDOR'S breach
intended. Goods shall be delivered free from any of section 11 (a) has occurred, or is likely to
security interest or other lien, encumbrance or occur, VENDOR may, at the COUNTY'S option,
claim of any third party. These warranties shall procure for the COUNTY the right to continue
survive inspection, acceptance, passage of title using the goods or services, or replace or modify
and payment by the COUNTY. the goods or services so that they become
non-infringing, (without any material degradation
8. Statutory Conformity in performance, quality, functionality or additional
Goods and services provided pursuant to this cost to the COUNTY).
Purchase Order, and their production and
transportation shall conform to all applicable 12. Insurance Requirements
laws, including but not limited to the Occupational The VENDOR, at its sole expense, shall provide
Health and Safety Act, the Federal commercial insurance of such type and with such
Transportation Act and the Fair Labor Standards terms and limits as may be reasonably
Act, as well as any law or regulation noted on the associated with the Purchase Order. Providing
face of the Purchase Order. and maintaining adequate insurance coverage is
a material obligation of the VENDOR. All
9. Advertising insurance policies shall be executed through
No VENDOR providing goods and services to the insurers authorized or eligible to write policies in
COUNTY shall advertise the fact that it has the State of Florida.
contracted with the COUNTY for goods and/or
services, or appropriate or make use of the 13. Compliance with Laws
COUNTY'S name or other identifying marks or In fulfilling the terms of this Purchase Order,
property without the prior written consent of the VENDOR agrees that it will comply with all
COUNTY'S Purchasing Department. federal, state, and local laws, rules, codes, and
ordinances that are applicable to the conduct of : ,,
its business. By way of non-exhaustive example,
10. Indemnification this shall include the American with Disabilities
Act and all prohibitions against discrimination on
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the basis of race, religion, sex creed, national conditions of this Purchase Order, provided that
origin, handicap, marital status, or veterans' COUNTY has provided VENDOR with notice of
status. Further, VENDOR acknowledges and such breach and VENDOR has failed to cure
without exception or stipulation shall be fully within 10 days of receipt of such notice.
responsible for complying with the provisions of
the Immigration Reform and Control Act of 1986 19. General
as located at 8 U.S.C. 1324, et seq. and a) This Purchase Order shall be governed by
regulations relating thereto, as either may be the laws of the State of Florida. The venue
amended. Failure by the awarded firm(s) to for any action brought to specifically enforce
comply with the laws referenced herein shall any of the terms and conditions of this
constitute a breach of the award agreement and Purchase Order shall be the Twentieth
the County shall have the discretion to Judicial Circuit in and for Collier County,
unilaterally terminate said agreement Florida
immediately. Any breach of this provision may b) Failure of the COUNTY to act immediately in
be regarded by the COUNTY as a material and response to a breach of this Purchase Order
substantial breach of the contract arising from by VENDOR shall not constitute a waiver of
this Purchase Order. breach. Waiver of the COUNTY by any
default by VENDOR hereunder shall not be
14. Force Majeure deemed a waiver of any subsequent default
Neither the COUNTY nor VENDOR shall be by VENDOR.
responsible for any delay or failure in c) All notices under this Purchase Order shall
performance resulting from any cause beyond be sent to the respective addresses on the
their control, including, but without limitation to face page by certified mail, return receipt
war, strikes, civil disturbances and acts of nature. requested, by overnight courier service, or by
When VENDOR has knowledge of any actual or personal delivery and will be deemed
potential force majeure or other conditions which effective upon receipt. Postage, delivery and
will delay or threatens to delay timely other charges shall be paid by the sender. A
performance of this Purchase Order, VENDOR party may change its address for notice by
shall immediately give notice thereof, including all written notice complying with the
relevant information with respects to what steps requirements of this section.
VENDOR is taking to complete delivery of the d) The Vendor agrees to reimbursement of any
goods and/or services to the COUNTY. travel expenses that may be associated with
this Purchase Order in accordance with
15. Assignment Florida Statute Chapter 112.061, Per Diem
VENDOR may not assign this Purchase Order, and Travel Expenses for Public Officers,
nor any money due or to become due without the employees and authorized persons.
prior written consent of the COUNTY. Any e) In the event of any conflict between or
assignment made without such consent shall be among the terms of any Contract Documents
deemed void. related to this Purchase Order, the terms of
the Contract Documents shall take
16. Taxes precedence over the terms of the Purchase
Goods and services procured subject to this Order. To the extent any terms and for
Purchase Order are exempt from Florida sales conditions of this Purchase Order duplicate
and use tax on real property, transient rental or overlap the Terms and Conditions of the
property rented, tangible personal purchased or Contract Documents, the provisions of the
rented, or services purchased (Florida Statutes, Terms and/or Conditions that are most
Chapter 212), and from federal excise tax. favorable to the County and/or provide the
greatest protection to the County shall
17. Annual Appropriations govern.
The COUNTY'S performance and obligation to
pay under this Purchase Order shall be
contingent upon an annual appropriation of
funds.
18. Termination
This Purchase Order may be terminated at any
time by the COUNTY upon 30 days prior written
notice to the VENDOR. This Purchase Order
may be terminated immediately by the COUNTY
for breach by VENDOR of the terms and
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Exhibit IV: Additional ITB Terms and Conditions
1. Additional Items and/or Services
During the contract term, Collier County reserves the right to add related items and/or services
upon negotiation of a satisfactory price by the Project Manager and Vendor.
2. Conflict of Interest
Vendor shall provide a list of any businesses and/or organizations to which the firm has any
affiliation or obligations within the past five (5) years; whether paid or donated, which could be
construed by the County as a conflict of interest. Disclosure of any potential or actual conflict of
interest is subject to County staff review and does not in and of itself disqualify a firm from
consideration. These disclosures are intended to identify and or preclude conflict of interest
situations during contract selection and execution.
3. Vendor Performance Evaluation
Collier County has implemented a Vendor Performance Evaluation System for all contracts
awarded in excess of$25,000. To this end, vendors will be evaluated on their performance upon
completion/termination of agreement.
5. Use of Subcontractors
Bidders on any service related project, including construction, must be qualified and directly
responsible for 51% or more of the solicitation amount for said work.
6. Deductions for Non-Performance
The County reserves the right to deduct a portion of any invoice for goods not delivered, or
services not performed in accordance with requirements, including required timeframe. The
County may also deduct, or chargeback the Vendor the costs necessary to correct the deficiencies
directly related to the Vendor's non-performance.
7. Offer Extended to Other Governmental Entities
Collier County encourages and agrees to the successful vendor extending the pricing, terms and
conditions of this solicitation or resultant contract to other governmental entities at the discretion of
the successful vendor.
8. Environmental Health and Safety
All Vendors and Sub vendors performing service for Collier County are required and shall comply
with all Occupational Safety and Health Administration (OSHA), State and County Safety and
Occupational Health Standards and any other applicable rules and regulations. Vendors and Sub
vendors shall be responsible for the safety of their employees and any unsafe acts or conditions
that may cause injury or damage to any persons or property within and around the work site. All
firewall penetrations must be protected in order to meet Fire Codes.
Collier County Government has authorized OSHA representatives to enter any Collier County
facility, property and/or right-of-way for the purpose of inspection of any Vendor's work operations.
This provision is non-negotiable by any department and/or Vendor.
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All new electrical installations shall incorporate NFPA 70E Short Circuit Protective Device
Coordination and Arc Flash Studies where relevant as determined by the engineer.
All electrical installations shall be labeled with appropriate NFPA 70E arch flash boundary and
PPE Protective labels.
9. Standards of Conduct
The Vendor shall employ people to work on County projects who are neat, clean, well-groomed
and courteous. Subject to the American with Disabilities Act, Vendor shall supply competent
employees who are physically capable of performing their employment duties. The County may
require the Vendor to remove an employee it deems careless, incompetent, insubordinate or
otherwise objectionable and whose continued employment on Collier County projects is not in the
best interest of the County.
10. Licenses
The Vendor is required to possess the correct professional and other licenses, and any other
authorizations necessary to perform the required work pursuant to all applicable Federal, State
and Local Law, Statute, Ordinances, and rules and regulations of any kind. Additionally, copies
of all the required licenses must be submitted with the bid response indicating that the
entity bidding, as well as the team assigned to the County account, is properly licensed to
perform the activities or work included in the ITB documents. Failure on the part of any
vendor to supply this documentation with their bid response may be grounds for deeming
vendor non-responsive. A Vendor with an office within Collier County is required to have an
occupational license.
All State Certified contractors who may need to pull Collier County permits or call in inspections
must complete a Collier County Contractor License registration form and submit the required fee.
After registering the license/registration will need to be renewed thereafter to remain "active" in
Collier County.
Questions regarding professional licenses should be directed to Contractor Licensing, Community
Development and Environmental Services at (239) 252-2431, 252-2432 or 252-2909. Questions
regarding required Business Tax Receipt (formerly known as Occupational Licenses) should be
directed to the Tax Collector's Office at (239) 252-2477.
11. Protection of Property
The Vendor shall ensure that the service is performed in such manner as to not damage any
property. In the event damage occurs to any property as a direct result of the Vendor or their Sub
vendor in the performance of the required service, the Vendor shall repair/replace, to the County's
satisfaction, damaged property at no additional cost to the County. If the damage caused by the
Vendor or their Sub vendor has to be repaired/replaced by the County, the cost of such work will
be deducted from the monies due the Vendor.
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12. Prohibition of Gifts to County Employees
No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan,
fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III,
Florida Statutes, the current Collier County Ethics Ordinance and County Administrative
Procedure 5311. Violation of this provision may result in one or more of the following
consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact
with County staff for a specified period of time; b. Prohibition by the individual and/or firm from
doing business with the County for a specified period of time, including but not limited to:
submitting bids, RFP, and/or quotes; and, c. immediate termination of any contract held by the
individual and/or firm for cause.
13. Invoice and Payments
Payments are made in accordance with the Local Government Prompt Payment Act, Chapter 218,
Florida Statutes. Vendor's invoices must include:
• Purchase Order Number
• Description and quantities of the goods or services provided per instructions on the County's
purchase order or contract.
• List Price
• Discounted price
• Package Quantity
Invoices shall be sent to:
Board of County Commissioners
Clerk's Finance Department
ATTN: Accounts Payable
3299 Tamiami Trail E Ste 700
Naples FL 34112
Or emailed to: bccaoclerkCa�collierclerk.com.
Collier County, in its sole discretion, will determine the method of payment for goods and/or
services as part of this agreement.
Payment methods include:
• Traditional—payment by check, wire transfer or other cash equivalent.
• Standard—payment by purchasing card. Collier County's Purchasing Card Program is
supported by standard bank credit suppliers (i.e. VISA and MasterCard), and as such, is cognizant
of the Rules for VISA Merchants and MasterCard Merchant Rules.
The County may not accept any additional surcharges (credit card transaction fees) as a result of
using the County's credit card for transactions relating to this solicitation. The County will
entertain bids clearly stating pricing for standard payment methods. An additional separate
discounted price for traditional payments may be provided at the initial bid submittal if it is clearly
marked as an "Additional Cash Discount."
Upon execution of the Contract and completion of each month's work, payment requests may be
submitted to the Project Manager on a monthly basis by the Contractor for services rendered for
that prior month. Services beyond sixty (60) days from current monthly invoice will not be
considered for payment without prior approval from the Project manager. All invoices should be
submitted within the fiscal year the work was performed. (County's fiscal year is October 1 -
September 30.) Invoices submitted after the close of the fiscal year will not be accepted (or
processed for payment) unless specifically authorized by the Project Manager.
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Payments will be made for articles and/or services furnished, delivered, and accepted, upon
receipt and approval of invoices submitted on the date of services or within six (6) months after
completion of contract. Any untimely submission of invoices beyond the specified deadline period
is subject to non-payment under the legal doctrine of"laches" as untimely submitted. Time shall be
deemed of the essence with respect to the timely submission of invoices under this agreement.
In instances where the successful contractor may owe debts (including, but not limited to taxes or
other fees) to Collier County and the contractor has not satisfied nor made arrangement to satisfy
these debts, the County reserves the right to off-set the amount owed to the County by applying
the amount owed to the vendor or contractor for services performed of for materials delivered in
association with a contract.
Invoices shall not reflect sales tax. After review and approval, the invoice will be transmitted to the
Finance Division for payment. Payment will be made upon receipt of proper invoice and in
compliance with Chapter 218 Florida Statutes, otherwise known as the"Local Government Prompt
Payment Act." Collier County reserves the right to withhold and/or reduce an appropriate amount
of any payment for work not performed or for unsatisfactory performance of Contractual
requirements.
Invoice Verification
It is requested that the vendor provide a real time, web-based online pricing system that reflects
the actual pricing the County will pay for each item ordered. Vendor will be responsible for
updating the web site to reflect approved pricing changes immediately upon approval. The County
reserves the right to request a demo of the online system prior to award of any contract. If such a
system is not available, please explain how invoices will be validated.
14. Survivability
Bids (ITBs/RFPs): The Consultant/ContractorNendor agrees that any Work Order/Purchase
Order that extends beyond the expiration date of Solicitation 13-6018—Fasteners and Wheel
Weights resultant of this solicitation will survive and remain subject to the terms and conditions of
that Agreement until the completion or termination of any Work Order/Purchase Order.
15. Insurance Requirements
The Vendor shall at its own expense, carry and maintain insurance coverage from responsible
companies duly authorized to do business in the State of Florida as set forth in Insurance and
Bonding Requirements Attachment of this solicitation. The Vendor shall procure and maintain
property insurance upon the entire project, if required, to the full insurable value of the scope of
work.
The County and the Vendor waive against each other and the County's separate Vendors,
Contractors, Design Consultant, Subcontractors agents and employees of each and all of them, all
damages covered by property insurance provided herein, except such rights as they may have to
the proceeds of such insurance. The Vendor and County shall, where appropriate, require similar
waivers of subrogation from the County's separate Vendors, Design Consultants and
Subcontractors and shall require each of them to include similar waivers in their contracts.
Collier County shall be responsible for purchasing and maintaining, its own liability insurance.
Certificates issued as a result of the award of this solicitation must identify "For any and all work
performed on behalf of Collier County."
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The General Liability Policy provided by Vendor to meet the requirements of this solicitation shall
name Collier County, Florida, as an additional insured as to the operations of Vendor under this
solicitation and shall contain a severability of interests provisions.
"Certificate County Board of County Commissioners shall be named as the Certificate Holder. The
Certificate Holder" should read as follows:
Collier County
Board of County Commissioners
Naples, Florida
The amounts and types of insurance coverage shall conform to the minimum requirements set
forth in the Insurance and Bonding Requirements Attachment, with the use of Insurance Services
Office (ISO) forms and endorsements or their equivalents. If Vendor has any self-insured
retentions or deductibles under any of the below listed minimum required coverage, Vendor must
identify on the Certificate of Insurance the nature and amount of such self- insured retentions or
deductibles and provide satisfactory evidence of financial responsibility for such obligations. All
self-insured retentions or deductibles will be Vendor's sole responsibility.
Coverage(s) shall be maintained without interruption from the date of commencement of the Work
until the date of completion and acceptance of the scope of work by the County or as specified in
this solicitation, whichever is longer.
The Vendor and/or its insurance carrier shall provide 30 days written notice to the County of policy
cancellation or non-renewal on the part of the insurance carrier or the Vendor. The Vendor shall
also notify the County, in a like manner, within twenty-four(24) hours after receipt, of any notices
of expiration, cancellation, non-renewal or material change in coverage or limits received by
Vendor from its insurer and nothing contained herein shall relieve Vendor of this requirement to
provide notice. In the event of a reduction in the aggregate limit of any policy to be provided by
Vendor hereunder, Vendor shall immediately take steps to have the aggregate limit reinstated to
the full extent permitted under such policy.
Should at any time the Vendor not maintain the insurance coverage(s) required herein, the
County may terminate the Agreement or at its sole discretion shall be authorized to purchase
such coverage(s) and charge the Vendor for such coverage(s) purchased. If Vendor fails to
reimburse the County for such costs within thirty (30) days after demand, the County has the right
to offset these costs from any amount due Vendor under this Agreement or any other agreement
between the County and Vendor. The County shall be under no obligation to purchase such
insurance, nor shall it be responsible for the coverage(s) purchased or the insurance company or
companies used. The decision of the County to purchase such insurance coverage(s) shall in no
way be construed to be a waiver of any of its rights under the Contract Documents.
If the initial or any subsequently issued Certificate of Insurance expires prior to the completion of
the scope of work, the Vendor shall furnish to the County renewal or replacement Certificate(s) of
Insurance not later than ten (10) calendar days after the expiration date on the certificate. Failure
of the Vendor to provide the County with such renewal certificate(s) shall be considered
justification for the County to terminate any and all contracts.
15. Collier County Information Technology Requirements
All vendor access will be done via VPN access only. All access must comply with current
published County Manager Agency (CMA) policies.
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Current policies that apply are CMAs 5402, 5403 and 5405. These policies will be available upon
request from the Information Technology Department. All vendors will be required to adhere to IT
policies for access to the County network. Vendors are required to notify the County in writing
twenty-four (24) hours in advance as to when access to the network is planned. Included in this
request must be a detailed work plan with actions that will be taken at the time of access. The
County IT Department has developed a Technical Architecture Requirements Document that is
required to be filled out and submitted with your bid response. This document can be found on the
Collier County Purchasing Department website: www.collierqov.net/purchasinq. On the left hand
side of the menu, click on CC Technical Requirements. If this document is not submitted with your
bid response, your bid response may be deemed non-responsive.
16. Security and Background Checks
If required, Vendor/Contractor/ Proposer shall be responsible for the costs of providing
background checks by the Collier County Facilities Management Department, and drug testing for
all employees that shall provide services to the County under this Agreement. This may include,
but not be limited to, checking federal, state and local law enforcement records, including a state
and FBI fingerprint check, credit reports, education, residence and employment verifications and
other related records. Contractor shall be required to maintain records on each employee and
make them available to the County for at least four (4) years.
17. Debris
Vendor shall be responsible for the removal and disposal of all debris from the site and the
cleaning of the affected areas. Vendor shall keep the premises free of debris and unusable
materials resulting from their work and as work progresses; or upon the request of the County's
representative, shall remove and dispose such debris and materials from the property. The
Vendor shall leave all affected areas as they were prior to beginning work.
18. Direct Material Purchase
The County reserves the right to require Vendor to assign some or all of its agreements with
material suppliers directly to the County. Any such goods and/or materials purchased by the
County pursuant to such an assignment of a material supply agreement shall be referred to as
"County Furnished Materials" and the responsibilities of both the County and the Vendor relating
to said materials shall be governed by the terms and conditions of this solicitation.
Additionally, the County at its sole option may choose to purchase some or all of the goods and/or
materials from other suppliers. In either instance the County may require the following information
from the Vendor:
• Required quantities of material.
• Specifications relating to goods and/or materials required for job including brand and/or model
number or type if applicable
• Pricing and availability of goods and/or materials provided under Vendor's agreements with
material suppliers
19. Grant Compliance
The purchase of any goods and/or services that are funded through Federal Grant Appropriations,
the State of Florida, or any other public or private foundations shall be subject to the compliance
and reporting requirements of the granting agency.
20. Equipment
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Vendor shall have available and in good working condition, the necessary equipment to perform
the required service. If required, the Vendor shall supply a list of equipment and an hourly rate for
each. Hourly rates will commence once equipment arrives at the service site.
In the event that additional specialized and/or heavy equipment (backhoe, crane, mudhog, etc.) is
needed, the Project Manager must be notified in advance for approval. The reimbursement of
additional equipment expense shall be at cost and will commence once equipment arrives at the
service site. The County reserves the right to request and obtain documentation of the Vendor's
cost, and to withhold payments until documentation is provided.
The scope of these specifications is to ensure the delivery of a complete unit ready for operation.
Omission of any essential detail from these specifications does not relieve the Vendor from
furnishing a complete unit.
All equipment must be new and of current manufacture in production at the time of ITB opening,
and carry standard warranties. At the time of delivery, at least two (2) complete shop repair
manuals and parts lists must be furnished with each type of equipment. Vendor must service all
equipment prior to delivery and/or acceptance by the County.
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Caper County
Administrative Services Division
Purchasing
Attachment 1: Vendor Submittal -Vendor's Non-Response Statement
The sole intent of the Collier County Purchasing Department is to issue solicitations that are clear,
concise and openly competitive. Therefore, we are interested in ascertaining reasons why prospective
Vendors did not wish to respond to this ITB. If your firm is not responding to this ITB, please indicate
the reason(s) by checking any appropriate item(s) listed below and return this form via email or fax to
the Procurement Strategist listed on the first page or mail to: Collier County Purchasing Department,
3327 Tamiami Trail East, Naples, Florida 34112.
We are not responding to this ITB for the following reason(s):
Solicitation: 13-6018—Fasteners and Wheel Weights
❑ Services requested not available through our company.
❑ Our firm could not meet specifications/scope of work.
❑ Specifications/scope of work not clearly understood (too vague, rigid, etc.)
❑ Project is too small.
❑ Insufficient time allowed for preparation of response.
❑ Incorrect address used. Please correct mailing address:
❑ Other reason(s):
Firm's Complete Legal Name
Address
City, State, Zip
Telephone Number
FAX Number
Signature/Title
Type Name of Signature Date:
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ier County
:.
Administrative Services Division
Purchasing
Attachment 2: Vendor's Check List
IMPORTANT: THIS SHEET MUST BE SIGNED BY VENDOR. Please read carefully, sign in the
spaces indicated and return with bid.
Vendor should check off each of the following items as the necessary action is completed:
1. The Bid has been signed.
2. The Bid prices offered have been reviewed.
3. The price extensions and totals have been checked.
4. The payment terms have been indicated.
5. Any required drawings, descriptive literature, etc. have been included.
6. Any delivery information required is included.
7. If required, the amount of bid bond has been checked, and the bid bond or cashiers check has
been included.
8. Addendum have been signed and included, if applicable.
9. Affidavit for Claiming Status as a Local Business, if applicable.
10. Immigration Affidavit and company's E-Verify profile page or memorandum of understanding.
11. Copies of licenses, equipment lists, subcontractors or any other information as noted in this
ITB.
12. The mailing envelope must be addressed to:
Purchasing Director
Collier County Government
Purchasing Department
3327 Tamiami Trail E
Naples FL 34112
The mailing envelope must be sealed and marked with:
• Solicitation: 13-6018— Fasteners and Wheel Weights
• Opening Date: 04/22/2013
13. The bid will be mailed or delivered in time to be received no later than the specified opening date
and time. (Otherwise bid cannot be considered.)
ALL COURIER DELIVERED BIDS MUST HAVE THE BID NUMBER AND TITLE ON THE OUTSIDE
OF THE COURIER PACKET.
Company Name
Signature & Title
Date
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Crier County
Administrative Services Division
Purchasing
Attachment 3: Vendor Submittal - Bid Response Form
FROM:
Board of County Commissioners
Collier County Government Center
Naples, Florida 34112
RE: Solicitation: 13-6018—Fasteners and Wheel Weights
Dear Commissioners:
The undersigned, as Vendor, hereby declares that the specifications have been fully examined and
the Vendor is fully informed in regard to all conditions pertaining to the work to be performed for as
per the scope of work. The Vendor further declares that the only persons, company or parties
interested in this Bid or the Contract to be entered into as principals are named herein; that this Bid is
made without connection with any other person, company or companies submitting a Bid; and it is all
respects fair and in good faith, without collusion or fraud.
The Vendor proposes and agrees if this Bid is accepted, to contract, either by a County issued
purchase order or formal contract, to comply with the requirements in full in accordance with the
terms, conditions and specifications denoted herein, according to the following unit prices:
1. Percentage Discount from List Price on entire catalog
101.Bid Total
Any discounts or terms must be shown on the Bid Response Form. Such discounts, if any, will be
considered and computed in the tabulation of the bids. In no instance should terms for less than
fifteen (15) days payment be offered.
Prompt Payment Terms: % Days; Net_Days
Bid Response Form is electronic. Please input line 101. Bid Total, in the online system.
Note: If you choose to bid manually, please submit an ORIGINAL and ONE COPY of your bid
response pages. The undersigned do agree that should this Bid be accepted, to execute a formal
contract, if required, and present the formal contract to the County Purchasing Director for approval
within fifteen (15) days after being notified of an award.
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IN WITNESS WHEREOF, WE have hereunto subscribed our names on this day of
, 20 in the County of , in the State of
Firm's Complete Legal Name
Address
City, State, Zip
Florida Certificate of Authority
Document Number
Federal Tax Identification
Number
CCR#or CAGE Code
Telephone Number
FAX Number
Signature/Title
Type Name of Signature
Date
**************************************************************************,*************************
Additional Contact Information
Send Payments To: (REQUIRED ONLY if different from above)
Firm's Complete Legal Name
Address
City, State, Zip
Contact Name
Telephone Number
FAX Number
Email Address
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Crier C.ounty
Pdrninistraiive Services Division
Purchasing
Attachment 4: Vendor Submittal— Local Vendor Preference Affidavit
Solicitation: 13-5018—Fasteners and Wheel Weights(Check Appropriate Boxes Below)
State of Florida(Select County if Vendor is described as a Local Business
❑ Collier County
❑ Lee County
Vendor affirms that it is a local business as defined by the Purchasing Policy of the Collier County Board of
County Commissioners and the Regulations Thereto. As defined in Section XI of the Collier County Purchasing
Policy;
A"local business" is defined as a business that has a valid occupational license issued by either Collier or Lee
County for a minimum of one(1) year prior to a Collier County bid or proposal submission that authorizes the
business to provide the commodities or services to be purchased, and a physical business address located
within the limits of Collier or Lee Counties from which the vendor operates or performs business. Post Office
Boxes are not verifiable and shall not be used for the purpose of establishing said physical address. In addition
to the foregoing, a vendor shall not be considered a"local business" unless it contributes to the economic
development and well-being of either Collier or Lee County in a verifiable and measurable way. This may
include, but not be limited to, the retention and expansion of employment opportunities, the support and
increase to either Collier or Lee County's tax base, and residency of employees and principals of the business
within Collier or Lee County. Vendors shall affirm in writing their compliance with the foregoing at the time of
submitting their bid or proposal to be eligible for consideration as a"local business" under this section.
Vendor must complete the following information:
Year Business Established in ❑Collier County or❑ Lee County:
Number of Employees (Including Owner(s) or Corporate Officers):
Number of Employees Living in ❑ Collier County or❑ Lee (Including Owner(s)or Corporate Officers):
If requested by the County, vendor will be required to provide documentation substantiating the information
given in this affidavit. Failure to do so will result in vendor's submission being deemed not applicable.
Vendor Name: Date:
Address in Collier or Lee County:
Signature: Title:
STATE OF FLORIDA
❑ COLLIER COUNTY ❑ LEE COUNTY
Sworn to and Subscribed Before Me, a Notary Public,for the above State and County, on this Day
of , 20
Notary Public
My Commission Expires:
(AFFIX OFFICIAL SEAL)
28
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cr�'covmty
Administrative Services Division
Purchasing
Attachment 5: Vendor Submittal—Immigration Affidavit
Solicitation: 13-6018—Fasteners and Wheel Weights
This Affidavit is required and should be signed, notarized by an authorized principal of the firm and submitted with formal
Invitations to Bid (ITB's) and Request for Proposals (RFP) submittals. Further, Vendors/Bidders are required to enroll
in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the
vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company
Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Failure to
include this Affidavit and acceptable evidence of enrollment in the E-Verify program, may deem the Vendor/
Bidder's proposal as non-responsive.
Collier County will not intentionally award County contracts to any vendor who knowingly employs unauthorized alien
workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e) Section 274A(e) of
the Immigration and Nationality Act("INA").
Collier County may consider the employment by any vendor of unauthorized aliens a violation of Section 274A(e) of the
INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A(e) of the INA shall be
grounds for unilateral termination of the contract by Collier County.
Vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Immigration Act
and subsequent Amendment(s)) and agrees to comply with the provisions of the Memorandum of Understanding with E-
Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E-Verify), operated by the
Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the
Vendor's/ Bidder's proposal.
Company Name .. ..;
Print Name
Title
Signature
Date
State of
County of
The foregoing instrument was signed and acknowledged before me this day of 20
by
who has produced as identification.
(Print or Type Name) (Type of Identification and Number)
Notary Public Signature
Printed Name of Notary Public
Notary Commission Number/Expiration
The signee of this Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of
this affidavit to interrogatories hereinafter made.
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Co lter Cor .> ty
Aciministnstive Sergi Division
Purchasing
Attachment 6: Vendor Substitute W—9
Request for Taxpayer Identification Number and Certification
In accordance with the Internal Revenue Service regulations, Collier County is required to collect the following
information for tax reporting purposes from individuals and companies who do business with the County (including
social security numbers if used by the individual or company for tax reporting purposes). Florida Statute
119.071(5) require that the county notify you in writing of the reason for collecting this information, which will be
used for no other purpose than herein stated. Please complete all information that applies to your business and
return with your quote or proposal.
1. General Information (provide all information)
Taxpayer Name
(as shown on income tax return)
Business Name
(if different from taxpayer name)
Address City
State Zip
Telephone FAX Email
Order Information Remit/Payment Information
Address Address
City State Zip City State Zip
FAX FAX
Email Email
2. Company Status (check only one)
Individual/Sole Proprietor Corporation ___Partnership
_Tax Exempt(Federal income tax-exempt entity _Limited Liability Company
under Internal Revenue Service guidelines IRC
501 (c) 3) Enter the tax classification
(D =Disregarded Entity, C=Corporation, P=Partnership)
3. Taxpayer Identification Number(for tax reporting purposes only)
Federal Tax Identification Number(TIN)
(Vendors who do not have a TIN,will be required to provide a social security number prior to an award of the contract.)
4. Sign and Date Form
Certification: Under penalties of perjury, I certify that the information shown on this form is correct to my knowledge.
Signature Date
Title Phone Number
30
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Corer County
Administrative ices Divisbn
Purchasing
Attachment 7: Vendor Submittal -Insurance and Bonding Requirements
Insurance/Bond Type Required Limits
1. ®Worker's Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government
Compensation Statutory Limits and Requirements
2. ® Employer's Liability $500.000 single limit per occurrence
3. ® Commercial General Bodily Injury and Property Damage
Liability(Occurrence Form)
patterned after the current $1.000,000 single limit per occurrence, $2,000,000 aggregate for Bodily Injury
ISO form Liability and Property Damage Liability. This shall include Premises and
Operations; Independent Contractors; Products and Completed Operations
and Contractual Liability.
4. ® Indemnification To the maximum extent permitted by Florida law, the
ContractorNendor/Consultant shall indemnify and hold harmless Collier
County, its officers and employees from any and all liabilities, damages,
losses and costs, including, but not limited to, reasonable attorneys'fees and
paralegals'fees, to the extent caused by the negligence, recklessness, or
intentionally wrongful conduct of the Contractor/Vendor/Consultant or anyone
employed or utilized by the Contractor/Vendor/Consultant in the performance
of this Agreement. This indemnification obligation shall not be construed to
negate, abridge or reduce any other rights or remedies which otherwise may
be available to an indemnified party or person described in this paragraph.
This section does not pertain to any incident arising from the sole negligence
of Collier County.
4. ®Automobile Liability $ 1.000.000 Each Occurrence; Bodily Injury& Property Damage,
Owned/Non-owned/Hired; Automobile Included
5. ❑ Other insurance as ❑Watercraft $ Per Occurrence
noted:
❑ United States Longshoreman's and Harborworker's Act coverage shall be
maintained where applicable to the completion of the work.
$ Per Occurrence
❑ Maritime Coverage (Jones Act) shall be maintained where applicable to
the completion of the work.
$ Per Occurrence
❑Aircraft Liability coverage shall be carried in limits of not less than
$5,000,000 each occurrence if applicable to the completion of the Services
under this Agreement.
$ Per Occurrence
❑ Pollution $ Per Occurrence
❑ Professional Liability $
per claim and in
the aggregate
• $1,000,000 per claim and in the aggregate
• $2,000,000 per claim and in the aggregate
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❑ Project Professional Liability $ Per Occurrence
❑Valuable Papers Insurance $ Per Occurrence
6. ❑ Bid bond Shall be submitted with proposal response in the form of certified funds,
cashiers' check or an irrevocable letter of credit, a cash bond posted with the
County Clerk, or proposal bond in a sum equal to 5%of the cost proposal. All
checks shall be made payable to the Collier County Board of County
Commissioners on a bank or trust company located in the State of Florida and
insured by the Federal Deposit Insurance Corporation.
7. ❑ Performance and For projects in excess of$200,000, bonds shall be submitted with the
Payment Bonds executed contract by Proposers receiving award, and written for 100% of the
Contract award amount, the cost borne by the Proposer receiving an award.
The Performance and Payment Bonds shall be underwritten by a surety
authorized to do business in the State of Florida and otherwise acceptable to
Owner; provided, however, the surety shall be rated as"A-" or better as to
general policy holders rating and Class V or higher rating as to financial size
category and the amount required shall not exceed 5% of the reported policy
holders' surplus, all as reported in the most current Best Key Rating Guide,
published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New
York 10038.
8. ® Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is
required to meet. The same Vendor shall provide County with certificates of insurance meeting the
required insurance provisions.
9. ® Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for
Commercial General Liability where required.
10. ® The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board
of County Commissioners in Collier County, OR Collier County Government, OR Collier County. The
Certificates of Insurance must state the Contract Number, or Project Number, or specific Project
description, or must read: For any and all work performed on behalf of Collier County.
11. ® Thirty (30) Days Cancellation Notice required.
Vendor's Insurance Statement
We understand the insurance requirements of these specifications and that the evidence of insurability may
be required within five (5) days of the award of this solicitation.
Name of Firm Date
Vendor Signature
Print Name
Insurance Agency
Agent Name Telephone Number
32
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